Gonorrhoea is becoming harder to treat because key antibiotics are less effective, posing a great danger to human health, researchers have warned.
Experts have also raised concern about the high number of new gonorrhoea infections which they attribute to decreased condom use, increased urbanisation and travel and poor detection rates.
“The bacteria that causes gonorrhoea are particularly smart. Every time we use a new class of antibiotics to treat the infection, the bacteria evolve to resist them,” Dr Teodora Wi, medical officer for human reproduction at the World Health Organization, says.
She says: “This disease is normally treated within four days to a week, but now it either kills or makes patients stay longer in a hospital because of the resistance”.
The WHO reports widespread resistance to older and cheaper antibiotics. Some countries, particularly high-income ones where surveillance is best, are finding cases of the infection that are untreatable by all known antibiotics.
Anti-microbial resistance is used to describe what occurs when disease-causing organisms change in ways that make medicine ineffective in killing them.
Each year, an estimated 78 million people are infected with gonorrhoea. It affects the genitals, rectum and throat.
The infection, which in many cases has no symptoms on its own, affects women more, it can lead to pelvic inflammatory disease, ectopic pregnancy and infertility, as well as an increased risk of HIV.
The WHO Global Gonococcal Antimicrobial Surveillance Programme, which monitors trends in drug-resistant gonorrhoea, calls for new drugs to treat the bacterial infection.
According to their data from 2009 to 2014, 97 per cent of countries reported drug-resistant strains to Ciprofloxacin, increasing resistance to Azithromycin at 81 per cent and the emergence of resistance to the current last-resort treatment: the extended-spectrum Cephalosporins oral cefixime or injectable ceftriaxone at 66 per cent. Currently, in most countries, the extended-spectrum Cephalosporins are the only single antibiotic that remains effective for treating gonorrhoea. But, resistance to Cefixime and more rarely to Ceftriaxone has now been reported in more than 50 countries.
Data from 77 countries shows that antibiotic resistance is making gonorrhoea a common sexually-transmitted infection much harder, and sometimes impossible, to treat.
“These cases may just be the tip of the iceberg since systems to diagnose and report untreatable infections are lacking in lower-income countries where gonorrhoea is actually more common,” Dr Wi says.
The WHO has since updated global treatment recommendations in 2016, advising doctors to give only two antibiotics including Ceftriaxone and Azithromycin to gonorrhoea patients.
The findings were first published in the PLoS Medicine journal, highlighting increases in drug-resistant gonorrhoea, calling it a “serious situation”.
Researchers have also raised concern that the research and development pipeline for gonorrhoea is empty since there are no drugs lined for research.
“We have only three new candidate drugs in various stages of clinical development,” Dr Wi says.
She says the development of new antibiotics is not very attractive for commercial pharmaceutical companies. Treatments are taken for short periods of time.
Prof Samuel Kariuki, a microbiologist and head of the Centre for Microbiology Research at Kenya Medical Research Institute earlier said that researchers were running out of options for treating infections that were found in homes.