CDC worries about gonorrhea's growing antibiotic resistance

Amid growing public health concerns about antibiotic resistance, the Centers for Disease Control & Prevention (CDC) said July 14 that gonorrhea could be the next infection to see significantly decreased treatability.

According to the CDC report, the bacteria that causes the sexually transmitted disease appears to be becoming less responsive to doses of azithromycin, one of the drugs currently most commonly used to treat gonorrhea.

Usually, patients are prescribed one oral dose of azithromycin combined with an injection of ceftriaxone. But based on the agency’s surveillance data, the incidence of azithromycin-resistant gonorrhea increased 400 percent between 2013 and 2014. In 2013, only about 0.6 percent of gonorrhea cases didn’t respond to azithromycin treatment. By 2014, that was up to 2.5 percent.

To make matters worse, the CDC also says cases of gonorrhea are on the rise. About 800,000 people get gonorrhea every year in the U.S., but only half of those people are diagnosed or treated for the disease. Director of the CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD and Tuberculosis Prevention Jonathon Mermin, MD, said in a statement that reducing gonorrhea transmissions would be a big part of combating its growing antibiotic resistance. He said getting the STD under control now, with the CDC partnering with local health departments, would prevent even worse issues in the future. Containing drug-resistant gonorrhea is only one part of the federal government’s Combating Antibiotic Resistant Bacteria Action Plan.

For now, most cases of gonorrhea contracted in the U.S. still respond to the azithromycin/ceftriaxone combination. But the STD has already managed to evolutionarily thwart antibiotics previously used to treat it (including penicillin, tetracycline and fluoroquinolones), so experts worry it is only a matter of time before it adapts to avoid current treatments, too.

“The confluence of emerging drug resistance and very limited alternative options for treatment creates a perfect storm for future gonorrhea treatment failure in the U.S.,” Mermin said. “History shows us that bacteria will find a way to outlast the antibiotics we’re using to treat it. We are running just one step ahead in order to preserve the remaining treatment option for as long as possible.”