A study in JAMA finds that the last oral antibiotic used to treat a gonorrhea "super-strain" failed in nearly 7% of patients at a Canadian clinic, a finding that suggests the superbug is becoming nearly untreatable worldwide.
The study documents the first series of clinical failures of antibiotic cefixime in North America, causing alarm among U.S. health officials. Last summer, federal health officials urged physicians to stop using the oral antibiotic cefixime for routine cases of gonorrhea in an effort to prevent it from becoming less effective. Instead, physicians were told to use an injectible antibiotic called ceftriaxone.
For the study, researchers analyzed data on 133 patients being treated for Neisseria gonorrhoeae between May 2010 and April 2011 at a clinic in Canada.
Thirteen of the patients were not cured by cefixime, and nine of those patients had not had sexual contact that could have re-infected them. That's a 6.7% failure rate.
"We've been very concerned about the threat of potentially untreatable gonorrhea in the United States," says Gail Bolan, director of CDC's division for sexually transmitted diseases. Although drug-resistant strains have been discovered in Europe, Bolan notes that "this is the first time we've had such a report in the actual North American continent. We feel it's only a matter of time until resistance will occur in the United States."
Gonorrhea is the second most-common sexually transmitted disease in the country and it has "outsmarted" four classes of antibiotics since the 1940s, according to NPR's "Shots."
"[T]he antibiotic pipeline is running dry: continued investment in antibiotic development is critical," CDC researchers wrote in an accompanying editorial, adding, "Clinicians, drug developers, and public health professionals must act now" (Doucleff, "Shots," NPR, 1/8; Reuters/New York Daily News, 1/9; Laidman, Medscape Today, 1/8).
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