Gonorrhea may soon be resistant to all major antibiotics, health officials warn. The World Health Organization recently reported three confirmed cases of the sexually transmitted disease that did not respond to even last-resort drugs.
"We need new tools and systems for better prevention, treatment, earlier diagnosis, and more complete tracking and reporting of new infections, antibiotic use, resistance and treatment failures" said Marc Sprenger, director of antimicrobial resistance at the WHO.
WHO says it is finding widespread resistance to older and cheaper antibiotics. Some countries – particularly high-income ones, where surveillance is best – are finding cases of the infection that are untreatable by all known antibiotics.
"These cases may just be the tip of the iceberg, since systems to diagnose and report untreatable infections are lacking in lower-income countries where gonorroea is actually more common," said Dr. Teodora Wi, Medical Officer, Human Reproduction, at WHO.
Women at risk
Gonorrhea can infect the genitals, rectum, and throat. Complications disproportionally affect women, including pelvic inflammatory disease, ectopic pregnancy, and infertility, as well as an increased risk of HIV.
Decreasing condom use, increased urbanization and travel, poor infection detection rates, and inadequate or failed treatment all contribute to the increase.
Health officials say the R&D pipeline for gonorrhea is relatively empty, with only three promising new drugs in various stages of development: solithromycin, zoliflodacinm, and gepotidacin.
Development is slow because antibiotics aren't very attractive for drugmakers. Treatments are taken for only a short period of time compared to drugs for chronic diseases. Also, antibiotics become less effective as bacteria develop resistance to them, meaning that drugs become obsolete quickly.
Prevention offers the best near-term option, WHO officials say. Condom use and careful sexual practices can prevent most cases of the disease. Today, lack of public awareness, lack of training of health workers, and stigma around STDs are barriers to effective prevention.