Richard Hopley, M.D. | 03/09/2023Gonorrhea is the second most reported sexually-transmitted bacterial infection in the United States. The CDC estimates that 1.6 million new gonorrhea infections occur each year, and that half of those infections are resistant to at least one antibiotic. Gonococcal infections have critical implications to reproductive, maternal, and newborn health.
The Impact of Gonorrhea
- 5x increased risk of contracting HIV
- Infertility
- Inflammation, leading to pelvic inflammatory disease (PID) in women
- Ectopic pregnancy and maternal death
- First trimester abortion
- Severe neonatal eye infections that may cause blindness
One Remaining Gonorrhea Treatment
Today, the United States has just one remaining recommended gonorrhea treatment option. In 1993, options for treatment included ciprofloxacin (a fluoroquinolone) and two cephalosporins (ceftriaxone and cefixime). However, in the late 1990s and early 2000s, ciprofloxacin resistance was identified… and by 2006, almost 14% of gonorrhea samples were resistant to this antibiotic, in all regions of the country. Therefore, in 2007 the CDC stopped recommending fluoroquinolones as empiric treatment for gonorrhea entirely.
Increasing Resistance to Remaining Treatments
This left the cephalosporins, either cefixime or ceftriaxone, as the only remaining recommended treatments. However, the CDC has also observed worrisome trends of increasing cephalosporin resistance. Therefore, to preserve cephalosporins for as long as possible, only one regimen is recommended as first-line treatment for gonorrhea: a single 500 mg dose of the injectable cephalosporin, ceftriaxone. The entire world is working to combat this significant threat through rapidly tracking and treating these resistant infections, as well as developing innovative ways to combat resistance.
References:
https://www.cdc.gov/std/treatment-guidelines/gonorrhea-adults.htm
https://www.who.int/news-room/fact-sheets/detail/multi-drug-resistant-gonorrhoea