So-called ‘super gonorrhoea’ could have finally met its match in a brand new antibiotic – the first new treatment in decades for the globally troublesome sexually transmitted infection (STI).
More than 82 million new gonorrhoea infections are recorded worldwide every year, making it the third most common STI. The disease affects both men and women, and if left untreated can lead to infertility in women, life-threatening ectopic pregnancies, and pelvic inflammatory disease.
While most cases are treatable, in recent years health organisations have become increasingly concerned about the rise of super gonorrhoea, an antibiotic-resistant strain caused by Neisseria gonorrhoeae.
The World Health Organisation has classed the bacterium as a ‘priority pathogen’.
Now however, researchers from Switzerland and the US have developed a brand new ‘first-in-class’ antibiotic that targets the infection in a new way.
The drug, called zoliflodacin, has a unique action, inhibiting a crucial enzyme that is essential for bacteria reproduction.
Zoliflodacin was tested on 930 people with gonorrhoea in the US, South Africa, Thailand, Belgium and the Netherlands, making it the largest clinical trial ever for treatment of the disease.
Participants were either given the new antibiotic as a pill, or an injection of existing gonorrhoea treatment ceftriaxone in combination with an oral dose of the antibiotic azithromycin.
The trial not only showed zoliflodacin successfully neutralised the infection, but that the drug is safe for use.
‘The outcome of this study is a potential game changer for sexual health,’ said Dr Edward W Hook III, protocol chair for the study and emeritus professor of medicine at the University of Alabama, Birmingham.
‘In addition to the potential benefits for patients with infections with resistant strains of Neisseria gonorrhoeae, the potential lack of cross-resistance with other antibiotics and the oral route of administration will simplify gonorrhoea therapy for clinicians worldwide.’
However, laboratory tests showed Neisseria gonorrhoeae can evolve resistance to zoliflodacin, and so the drug is being developed only as a treatment for STIs and will not be used to treat other diseases.
Resistance to ceftriaxone is already widespread globally, while some strains are also showing resistance to azithromycin, leading to the super-strain.
‘This developing situation is a grave concern, because gonorrhoea might become untreatable,’ said Magnus Unemo, a microbiologist at Örebro University Hospital in Sweden.
However, the new study offers hope for patients and doctors worldwide, adding to their armoury in the battle against gonorrhoea.
‘Despite the extremely high public health value, there has been a lack of investment to develop new drugs for gonorrhoea,’ said Dr Manica Balasegaram, executive director of the Global Antibiotic Research and Development Partnership, which led the trial.
‘This zoliflodacin programme demonstrates that it is possible to develop antibiotic treatments targeting multidrug-resistant bacteria that pose the greatest public health threat, and which may not otherwise get developed.’
Last year the UK Health Security Agency warned a number of cases of super gonorrhoea in the UK, and in July cautioned holidaymakers against having unprotected sex to help prevent the spread of the untreatable strain.
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MORE : Gonorrhea diagnoses have hit an all time high. What is it and how can you avoid catching it?
MORE : How to bring up safe sex conversations with a partner
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