In case you haven't heard, some experts are warning that gonorrhea could soon be very difficult to treat. This worry is based on the infection's history of becoming resistant to certain antibiotics, which is actually downright terrifying.
According to the CDC, they updated their treatment guidelines in 2010 after lab data found that the antibiotic cefixime was becoming less effective against it. They changed the guidelines again in 2012 to ditch cefixime altogether and instead suggest an injectable antibiotic called ceftriaxone plus an oral antibiotic (either azithromycin or doxycycline). New data from the CDC seems to show that these bacteria are becoming easier to treat with these drugs, at least in the U.S., though more research is needed.
Unfortunately, there are still a few cases of drug-resistant strains of the infection popping up around the globe, the most recent of which occurred in December 2013 in Australia.
This particular case, detailed in a recent issue of the New England Journal of Medicine, involved a young woman who had sex with a new partner while traveling through Australia. She first developed vaginal discharge and visited one clinic, where she was tested for STDs and given antibiotics. When she continued having symptoms, she visited another clinic, where she told doctors that she had since received a phone call from the first office telling her she had gonorrhea.
"When we tested the gonorrhea bug from this patient for antibiotic resistance, we found that it was technically resistant to ceftriaxone," says study co-author David M. Whiley, M.D., of Queensland Children's Medical Research Institute. "We had never seen this type of gonorrhea resistance in Australia before, and so [it] was quite alarming. The patient was successfully treated with a combination of two drugs, ceftriaxone plus azithromycin."
So what do these reports tell us about the future of gonorrhea? "The history of gonorrhea resistance tells us that once the bug starts to show signs of resistance, then it is generally not very long, perhaps only a few years, before such strains become commonplace," says Whiley. "Reports of ceftriaxone-resistant gonorrhea have only been very sporadic, with only four to date. But combined they provide mounting evidence that gonorrhea may soon become very difficult to treat."
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The CDC confirms that they still only have one first-line of treatment, so new treatments are needed in case resistance to the current cure develops again, which can definitely happen. They are currently addressing this issue and monitoring trends through several initiatives, including the Gonococcal Isolate Surveillance Project (GISP), which looks at strains of gonorrhea in the U.S.
Okay, so this is all generally nightmare-inducing, but here's the good news: The vast majority of cases of gonorrhea are currently curable with antibiotics, and there are researchers working to ensure that we stay on top of any future antibiotic resistance. That said, this is just one more reason to practice safe sex (that means using a condom every single time until you're both mutually monogamous and know you're disease-free because yo've been tested).
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"There are already plenty of reasons why people should consider practicing safe sex, and, in my opinion, HIV remains on the top of that list," says Whiley. "The potential to acquire gonorrhea, including drug-resistant gonorrhea, is simply another good reason."
The CDC recommends annual screening for gonorrhea for any at-risk, sexually active women, so be sure to ask for it if you've been with anyone new since the last time you were tested. Here's why: Gonorrhea is often symptomless in women, though you may experience pain urinating, increased vaginal discharge, or bleeding between periods, according to the CDC. If you do test positive for gonorrhea, take the antibiotics according to your doctor, and check in with them. "If you are diagnosed with gonorrhea and you still have symptoms following treatment, then definitely get back to your doctor and let them know," says Whiley.
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