-- Robert Preidt
MONDAY, July 15 (HealthDay News) -- Two new promising treatments
for gonorrhea may help fight the growth of drug-resistant strains
of the sexually transmitted bacteria, according to a new U.S.
The two antibiotic regimens use existing drugs in new
combinations -- injectable gentamicin with azithromycin pills, or
gemifloxacin pills with azithromycin pills.
Gonorrhea is one of the most common sexually transmitted
diseases in the United States, with more than 800,000 new
infections estimated to occur each year, according to the U.S.
Centers for Disease Control and Prevention. Untreated, it can lead
to problems with the prostate and testicles for men, and
infertility in women. This is why its increasing
antibiotic-resistance is a serious concern.
The U.S. government study included more than 400 men and women,
aged 15 to 60, with untreated gonorrhea infection. The injectable
gentamicin/oral azithromycin combination was 100 percent effective
in curing genital gonorrhea infections, while the
gemifloxacin/azithromycin pill combination was 99.5 percent
effective. Both combinations cured 100 percent of infections of the
throat and rectum, the researchers noted.
However, many patients in both arms of the study reported
unpleasant side effects, including nausea, diarrhea and abdominal
discomfort/pain or vomiting.
The study, scheduled for presentation this week at a meeting of
the International Society for Sexually Transmitted Diseases
Research in Vienna, Austria, was conducted by the CDC and the U.S.
National Institutes of Health.
"These trial results are an exciting step in the right direction in the fight against drug-resistant gonorrhea," Dr. Gail Bolan, director of CDC's division of STD prevention, said in an agency news release. "But patients need more oral options with fewer side effects. It is imperative that researchers and pharmaceutical companies prioritize research to continue to identify new, effective, better-tolerated drugs and drug combinations."
Additional measures to stay ahead of resistant gonorrhea are
critical, Dr. Anthony Fauci, director of NIH's National Institute
of Allergy and Infectious Diseases, said in the news release. "For
example, a point-of-care drug susceptibility test would help
providers know -- at the time of diagnosis -- which treatment
regimen will be most effective," he said.
"Progress toward a vaccine is urgently needed," Fauci added.
These findings do not change current gonorrhea treatment
guidelines. The CDC recommends only one first-line treatment
regimen: injectable ceftriaxone, in combination with one of two
other antibiotics in pill form, either azithromycin or doxycycline.
This therapy is highly effective in treating gonorrhea and causes
limited side effects.
Ceftriaxone is in the same class of antibiotics as cefixime, a
pill that has lost effectiveness against the sexually transmitted
disease. Earlier this year, Canadian researchers reported on a
study of nearly 300 people infected with
Neisseria gonorrhoeaethat found a treatment failure rate of
nearly 7 percent in people treated with cefixime. Last August the
CDC advised doctors to stop using cefixime to treat gonorrhea, and
instead use injections of ceftriaxone.
However, doctors may consider using the treatments assessed in
this new study as alternative options when ceftriaxone can't be
used, such as in the case of a severe allergy, the CDC said. The
agency says it will consider the study's findings for inclusion in
future treatment guidelines.
To help prevent gonorrhea, people who are sexually active should
use condoms consistently and correctly, and limit the number of sex
partners, the CDC states.
The data and conclusions of research presented at medical
meetings should be viewed as preliminary until published in a
The U.S. National Institute of Allergy and Infectious Diseases
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