Gonorrhea is a sexually transmitted disease (STD) involving inflammatory discharge from the urethra or vagina. Gonorrhea affects about 0.8% of women and 0.6% of men. An estimated 33 to 106 million new cases occur each year, out of the 498 million new cases of curable STI – which also includes syphilis, chlamydia, and trichomoniasis.
The U.N. health agency released new guidelines warning doctors that it no longer recommends an entire class of antibiotics, quinolones, because quinolone-resistant strains of the disease have emerged all over the world.
Instead, the health agency recommends using cephalosporins, another class of antibiotic. The new protocol replaces guidelines that had not been changed since 2003.
According to the WHO, 78 million people are infected with gonorrhea every year.
Worldwide, health officials are concerned that overuse of antibiotics for other infections, such as urinary tract infections, will lead to widespread, untreatable strains of gonorrhea. In 2011, a super-resistant strain showed up in Japan.
Gonorrhea used to be susceptible to penicillin, ampicillin, tetracycline and doxycycline — very commonly used drugs. But one by one, each of those antibiotics — and almost every new one that has come along since — eventually stopped working. One reason is that the bacterium that causes gonorrhea can mutate quickly to defend itself.
The WHO shift to the new class of antibiotics will not fix that overall problem of bacterial creativity. In some countries, strains of gonorrhea are already resistant to the newly recommended class of drugs.
The U.S. Centers for Disease Control and Prevention warned back in 2012 that one of two drugs in the class of antibiotics the WHO now recommends, cephalosporins, was in danger of becoming useless to treat gonorrhea, at least in the U.S, and recommended that doctors stop prescribing it.
Since then, the CDC’s recommended treatment for gonorrhea has been a dual therapy, with the two antibiotics ceftriaxone and azithromycin, but an analysis in July warned that the bacteria could even become resistant to that combination.
Although all three sexually transmitted diseases affect both men and women, they can have particularly devastating effects on women if they are not treated. Gonorrhea can cause pelvic inflammatory disease and lead to dangerous ectopic pregnancies. Syphilis can pass from a pregnant woman to her fetus, and chlamydia can make it difficult for a woman to get pregnant.