Gonorrhea Drug Resistance Recedes With New U.K. Approach

Drug-resistant gonorrhea receded in the U.K. as doctors switched to a new combination of antibiotics to clear the sexually transmitted bacterium, a study found.

Analysis of more than 6,000 samples from clinics in England and Wales over five years showed that resistance to cefixime, a generic drug and the first-line treatment for gonorrhea since 2004, fell to 10.8 percent in 2011 from 17.1 percent in 2010, reversing a four-year surge, researchers from Public Health England wrote in The Lancet journal today.

The findings suggest that a 2010 change in U.K. treatment guidelines for gonorrhea may be working, the researchers wrote. The guidelines recommended doctors switch from cefixime, an oral treatment, to an injected antibiotic called ceftriaxone, in combination with another generic drug called azithromycin. Increasing resistance to cefixime is “a major public health challenge,” the World Health Organization said a year ago.

“Despite this apparent success in stopping the drift to resistance, this proactive approach to optimum stewardship of first-line treatment must be maintained,” wrote the researchers led by Cathy Ison, the director of the laboratory that monitors the disease.

About 106 million people globally are infected with gonorrhea each year, according to the Geneva-based WHO. Cases jumped by 21 percent in the U.K. last year, and by 37 percent among gay and bisexual men, according to Public Health England.

Sexual Contact

The disease is caused by bacteria transmitted by sexual contact and can result in a burning sensation when urinating in both men and women. Left untreated it can cause complications including infertility and a life-threatening infection of the blood and joints.

The bug has developed resistance to all drugs previously used as first-line treatment, and no obvious therapies are available should cefixime and ceftriaxone become useless, the researchers wrote.

Cempra Inc., a Chapel Hill, North Carolina-based drugmaker, is testing an experimental antibiotic called solithromycin in the second of three stages of trials normally needed for regulatory approval.

The study was funded by England’s Department of Health and Public Health England, the nation’s disease-tracking agency.

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