ATLANTA (AP) — The sexually transmitted disease gonorrhea is now among the
“superbugs” resistant to common antibiotics, leading U.S. health officials to
recommend wider use of a different class of drugs to avert a public health
crisis.
The resistant form accounts for more than one in every four gonorrhea cases
among heterosexual men in Philadelphia and nearly that many in San Francisco,
according to a survey that led to Thursday’s recommendation by the Centers
for Disease Control and Prevention.
Gonorrhea, which is believed to infect more than 700,000 people in the United
States each year, can leave both men and women infertile and puts people at
higher risk of getting the AIDS virus.
Since the early 1990s, a class of drugs known as fluoroquinolones has
provided a relatively easy cure. These antibiotics, taken as tablets, include
the drug Cipro.
But a growing number of gonorrhea cases is resistant to those drugs, and
officials at the CDC for the first time are urging doctors to stop using
fluoroquinolones and switch to cephalosporins, a different class of
antibiotics, to treat everyone.
Those drugs — which include the generic ceftriaxone or brand name Rocephin,
made by Swiss drug maker Roche Holding AG — must be given as a shot and
aren’t as readily stocked as Cipro on most doctor’s shelves.
“Gonorrhea has now joined the list of other superbugs for which treatment
options have become dangerously few,” said Dr. Henry Masur, president of the
Infectious Disease Society of America. “To make a bad problem even worse,
we’re also seeing a decline in the development of new antibiotics to treat
these infections.”
The CDC made the new recommendation after discovering that nearly 7 percent
of gonorrhea cases among heterosexual men in a survey of 26 U.S. cities last
year were drug-resistant. In 2001, only about 0.6 percent of gonorrhea cases
among heterosexual men were drug-resistant.
“That leaves us with a single class of highly effective antibiotics,” said
Dr. John Douglas Jr., director of the CDC’s division of STD prevention. Other
experts called the situation perilous.
“We are running out of options to treat this disease,” added Douglas, who
said there are “no new drugs for gonorrhea in the drug development pipeline.”
Previously, CDC recommended against fluoroquinolones to treat drug-resistant
gonorrhea among men who have sex with men and in certain states, including
California and Hawaii where most of these cases were turning up.
Described by Douglas as a “very wily” disease, gonorrhea has worked its way
through decades of other treatment regimens, from sulfa drugs used in the
1930s and 1940s, to penicillin, which was used from the 1940s until the
mid-1980s.
Gonorrhea, spread through sexual contact, is the second most commonly
reported infectious disease in the United States, trailing only chlamydia,
which the CDC says affects more than 2.1 million people yearly in the U.S.
The highest rates of infection are among sexually active teens, young adults
and African-Americans. Because many people don’t have obvious symptoms, they
can unknowingly spread it to others. And having it makes people more
susceptible to HIV. Gonorrhea’s spread is preventable through consistent and
proper use of condoms, experts said.
In women, the infection can cause pelvic inflammatory disease. In men, it can
cause epididymitis, a painful condition of the testicles that can lead to
infertility if untreated, the CDC said.
In the survey of gonorrhea cases among heterosexual men in 26 cities last
year, Philadelphia had the highest percentage of drug-resistant cases with
almost 27 percent, a dramatic increase from only 1.2 percent in 2004.
Posted 4/13/2007