New Hope for Treating Drug-Resistant Gonorrhea
Drug-resistant gonorrhea has increasingly become a concern, with the STI having adapted to long-used antibiotics. But a drug now in clinical trials shows promise for curing resistant strains.
"Gonorrhea spreads through sexual contact and can separately infect the genitals, rectum and throat," NBC News noted. "The STI is especially common among adolescents and young adults and occurs disproportionately among gay and bisexual men, the CDC reports.
"Left untreated, gonorrhea poses a risk of infertility and can prove especially damaging to women, leading to pelvic inflammatory disease and ectopic pregnancy. The infection can also raise the risk of HIV transmission."
The "new antibiotic," called zoliflodacin, "has proven as effective as the last remaining recommended treatment for gonorrhea, helping to assuage mounting fears among public health experts about the emergence of drug-resistant strains of the sexually transmitted infection," NBC News reported.
"Gonorrhea is the second most common STI in the U.S. and has developed resistance to all antibiotics used to treat it, except for the recommended combined therapy of an injection of the antibiotic ceftriaxone with one dose of azithromycin pills," the news report backgrounded. "In recent years, ominous reports have suggested that this antibiotic arsenal might not maintain its robust effectiveness against the fast-evolving pathogen for much longer."
That made the search for a new antibiotic against gonorrhea urgent as cases of untreatable strains of the disease increased around the world. Nature reported on the development of zoliflodacin in 2017, noting that although the drug had been scheduled for a phase II trial in 2015, "a lack of investment stopped the drug from progressing" for a time.
"Without a new antibiotic weapon, curing highly drug-resistant strains of gonorrhea could require intensive treatment with multiple antibiotics, according to Dr. Jeanne Marrazzo, director of the National Institute of Allergy and Infectious Diseases," NBC News noted. "This so-called kitchen-sink approach, she said, would strain medical resources and raise the risk of driving the emergence of further microbial drug resistance to those other antibiotics.
"The ultimate fear is that eventually, gonorrhea could prove wholly untreatable, in at least some people."
But the new treatment "attacks gonorrhea in a novel way," and has "proved effective at neutralizing gonorrhea strains that were highly resistant to ceftriaxone and azithromycin and strains that had resistance to other antibiotics as well," the news report added.
"A downside of zoliflodacin is that a previous, phase two clinical trial published in 2018 found that it was not as efficacious at treating gonorrhea infections in the throat as in the genital or rectal areas," NBC News went on to say. "However, Marrazzo, who was a co-author on that study, said that this disparity is common among gonorrhea treatments."
Marrazzo told the news outlet: "Gonorrhea in the throat is probably going to be a major Achilles heel in our battle to control gonorrhea going forward."
"But according to Dr. Margaret Koziel, chief medical officer of Innoviva, the new zoliflodacin trial showed 'encouraging' results in the small number of participants with rectal or throat infections," the NBC News relayed..
"The new zoliflodacin study enrolled 930 men, women and adolescents, including people with HIV, with uncomplicated gonorrhea at 16 trial sites in five nations, including Belgium, the Netherlands, South Africa, Thailand and the U.S.," the article detailed. "Participants were randomized to receive a single oral dose of zoliflodacin or a ceftriaxone injection plus oral azithromycin.
"The WHO has called the emergence of drug-resistant pathogens one of the top 10 global public health threats facing humanity and has identified gonorrhea in particular as a priority pathogen."