Antibiotic Resistant Gonorrhea: Treatment Down To Single Drug, CDC Says

By Amir Khan on August 10, 2012 8:38 AM EDT

Injection
Antibiotic resistant gonorrhea is spreading, and soon, it may become untreatable, according to the Centers for Disease Control and Prevention. The organization announced on Thursday that there is now only one antibiotic effective at treating the disease. (Photo: Creative Commons)

Antibiotic resistant gonorrhea is spreading, and soon, it may become untreatable, according to the Centers for Disease Control and Prevention. The organization announced on Thursday that there is now only one antibiotic effective at treating the disease.

"We're trying to sound the alarm to prevent untreatable gonorrhea from becoming a reality," Gail Bolan, director of the Division of STD Prevention at the CDC, told the Wall Street Journal. "We're very concerned."

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The only antibiotic left is a class of drugs known as cephalosporins, and the new CDC guidelines recommend an injection of the drug, meaning people with the disease can no longer take a pill to get rid of it.

Antibiotic resistant gonorrhea isn't a new problem. During World War II, gonorrhea became resistant to the drug sulfanilamide. In the 1980s, it became resistant to penicillin and tetracyclin. In 2007, the antibiotic fluoroquinolone stopped working.

People with gonorrhea often do not exhibit symptoms, but possible symptoms are vaginal discharge, lower abdominal pain or pain during intercourse. Men can also experience a burning sensation during urination. If left untreated, serious health issues can develop, including pelvic inflammatory disease, which can lead to infertility in women and is one reason the antibiotic resistant strain can be a huge problem.

But how do the bacteria that cause gonorrhea become resistant to antibiotics?

Antibiotics work by killing susceptible bacteria, but some microbes can survive because of an ability to neutralize or avoid an antibiotic. Resistant strains, either naturally or through mutations, survive, multiply and replace bacteria destroyed by antibiotics.

"Bacteria that were at one time susceptible to an antibiotic can acquire resistance through mutation of their genetic material or by acquiring pieces of DNA that code for the resistance properties from other bacteria," according to the CDC website. "The DNA that codes for resistance can be grouped in a single easily transferable package. This means that bacteria can become resistant to many antimicrobial agents because of the transfer of one piece of DNA."

Jonathan Zenilman, who studies infectious diseases at Johns Hopkins, told NPR that drug overuse is the major factor.

"A lot of this is occurring not because of treatment for gonorrhea but overuse for other infections, such as urinary tract infections, upper respiratory tract infections and so forth," he said.

The biggest contributor to bacteria drug resistance is the over-prescription of antibiotics, according to the CDC. Antibiotics are frequently prescribed for viruses, simply because healthcare providers think patients expect them. The common cold is the most common reason antibiotics are prescribed, despite the fact that antibiotics do not affect viruses.

Bolan said that new drugs need to be developed, but that pharmaceutical companies have had no incentive to.

"The business model has not been there for pharmaceutical companies to develop antimicrobials in our country," she said. 

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