Millions of people with gonorrhoea may be at risk of running out of treatment options unless urgent action is taken, according WHO. Already several countries, including Australia, France, Japan, Norway, Sweden and the United Kingdom are reporting cases of resistance to cephalosporin antibiotics – the last treatment option against gonorrhoea. Every year an estimated 106 million people are infected with gonorrhea, which is transmitted sexually.
Dwindling treatment options
“Gonorrhoea is becoming a major public health challenge, due to the high incidence of infections accompanied by dwindling treatment options,” says Dr Manjula Lusti-Narasimhan, from the Department of Reproductive Health and Research at WHO. “The available data only shows the tip of the iceberg. Without adequate surveillance we won’t know the extent of resistance to gonorrhoea and without research into new antimicrobial agents, there could soon be no effective treatment for patients.”
Correct use of antibiotics needed
In new guidance issued today, WHO is calling for greater vigilance on the correct use of antibiotics and more research into alternative treatment regimens for gonococcal infections. WHO’s Global Action Plan to control the spread and impact of antimicrobial resistance in Neisseria gonorrhoea also calls for increased monitoring and reporting of resistant strains as well as better prevention, diagnosis and control of gonococcal infections.
Health implications are important
Gonorrhoea makes up one quarter of the four major curable sexually-transmitted infections1. Since the development of antibiotics, the pathogen has developed resistance to many of the common antibiotics used as treatment, including penicillin, tetracyclines and quinolones.
“We are very concerned about recent reports of treatment failure from the last effective treatment option – the class of cephalosporin antibiotics – as there are no new therapeutic drugs in development,” says Dr Lusti-Narasimhan. “If gonococcal infections become untreatable, the health implications are significant.”
Antimicrobial resistance is caused by the unrestricted access to antimicrobials, overuse and poor quality of antibiotics, as well as natural genetic mutations within disease organisms. In addition, gonorrhoea strains tend to retain genetic resistance to previous antibiotics even after their use has been discontinued. The extent of this resistance worldwide is not known due to lack of reliable data for gonorrhoea in many countries and insufficient research.
Untreated gonococcal infection can cause health problems in men, women and newborn babies including:
- infection of the urethra, cervix and rectum;
- infertility in both men and women;
- a significantly increased risk of HIV infection and transmission;
- ectopic pregnancy, spontaneous abortion, stillbirths and premature deliveries; and
- severe eye infections occur in 30-50% of babies born to women with untreated gonorrhoea, which can lead to blindness.
Gonorrhoea can be prevented through safer sexual intercourse. Early detection and prompt treatment, including of sexual partners, is essential to control sexually transmitted infections.