- The Washington Times - Wednesday, August 27, 2014

Public health officials are sounding the alarm — again — about the looming problem of drug-resistant gonorrhea in the wake of a Swedish study about four cases that didn’t immediately respond to treatment.

The new “treatment failures” from Europe show the need for new anti-gonorrhea drugs, William Smith, executive director of the National Coalition of STD Directors, said Wednesday.

The coalition has also been calling for emergency funding for local health centers to respond to expected cases of drug-resistant gonorrhea, as well as better diagnostic tests for the infections.

Gonorrhea, a sexually transmitted disease seen since medieval times, was once dispatched by penicillin and several other classes of drugs. None of those old treatments are effective any more, as the gonorrhea organism has learned how to resist such drugs.

Currently, the Centers for Disease Control and Prevention (CDC) advise gonorrhea treatment of an injectable drug called ceftriaxone — which means a doctor visit — combined with one of two other oral antibiotics — azithromycin or doxycycline.

Ceftriaxone was described as the “last proven treatment option” by Dr. Kevin Fenton, former director of the CDC’s agency on AIDS and other sexually transmitted diseases.

In a July study in Eurosurveillance, Swedish researchers reported that four people who acquired gonorrhea through heterosexual activity in 2013 did not respond to their initial treatments.

Three people were eventually cured with a second shot of ceftriaxone, and one was cured with a second shot plus a single dose of azithromycin.

The Swedish study noted that gonorrhea infections in the throat have always been more difficult to treat than those in the urogenital or rectal areas.

According to the CDC, some 333,000 cases of gonorrhea were reported in 2013, making it the second most common bacterial sexually transmitted disease.

The CDC estimates that there are actually more than 800,000 gonorrhea cases in the United States because the infection can be asymptomatic in women and when it is in the throat or rectum.

Gonorrhea symptoms including open sores, genital discharge and painful urination. It is associated with ectopic pregnancies and pelvic inflammatory disease in women and can lead to sterility in both men and women. Gonorrhea infections also raise the risk for acquiring AIDS because its lesions permit the AIDS-causing virus to enter the bloodstream.