Federal health officials on Thursday announced that gonorrhea is nearing total antibiotic resistance and launched a "preemptive strike" to prevent the emergence of a gonorrhea "superbug."
In revised guidelines published in CDC's Morbidity and Mortality Weekly Report, the agency urged physicians to stop using the oral antibiotic cefixime for routine cases of gonorrhea because it is becoming less effective.
Cefixime has been used successfully to treat gonorrhea for years in the United States. However, recent samples of the sexually transmitted infection have shown signs of resistance to the treatment. Although no cases of treatment failure have been reported in the United States, antibiotic-resistant gonorrhea strains have been found in Asia and Europe, CDC officials say.
"We are very concerned about the possibility of the potential for untreatable gonorrhea," says Robert Kirkcaldy, a medical epidemiologist with the CDC's Division of STD Prevention. "Facing this threat of drug resistance, the CDC is taking the critical step to preserve the last remaining drug that we know to be effective. We're hoping that the actions taken now will prevent that from becoming a reality."
The new guidelines leave only one recommended treatment for gonorrhea, one of the most common STIs in the United States.
Instead of cefixime, marketed under the brand name Suprax, patients should take the injectable antibiotic ceftriaxone, marketed under the brand name Rocephin, the CDC guidelines say.
The guidelines also call on physicians to monitor patients closely for signs of resistance.
CDC officials called the recommendation a "preemptive strike" to preserve one of gonorrhea's last available treatment options. Gail Bolan—director of the STD prevention division at CDC—said the new recommendations "may buy us time" to discover a new class of anti-gonorrhea drugs.
"Currently there is just one promising new gonorrhea drug in the pipeline and only one clinical trial is under way to examine treatment options for gonorrhea using new combinations of existing drugs," Bolan said. She added, "Multiple drugs will need to be studied to find a few that are safe and effective" (Norman, CQ HealthBeat, 8/9 [subscription required]; Wetzstein, Washington Times, 8/9; Steenhuysen, Reuters, 8/10; McKay, "Health Blog," Wall Street Journal, 8/9; Gardner, HealthDay, 8/9; Smith, MedPage Today, 8/9).