CHICAGO Aug 9 U.S. health officials are urging
doctors to stop using a key antibiotic to treat routine cases of
gonorrhea due to signs of bacterial resistance, leaving one
treatment left for the sexually transmitted disease.
The U.S. Centers for Disease Control and Prevention said on
Thursday it no longer recommends the use of cefixime, marketed
under the brand name Suprax by Lupin Ltd, because it
is becoming less effective. That leaves the injectable generic
antibiotic ceftriaxone, used in combination with another
antibiotic, as the last treatment option.
"The change in antibiotic treatment guidelines we are making
today is a critical pre-emptive strike to preserve the last
effective treatment option," said Dr. Gail Bolan, director of
the CDC's Sexually Transmitted Disease Prevention division.
"This will not solve the problem of drug-resistant gonorrhea
once and for all, but it may buy us time to allow researchers
and drug developers to develop new treatments," Bolan told
reporters in a telephone briefing.
Until new treatments reach the market, experts say the best
way to reduce the risk of drug-resistant gonorrhea is to rapidly
diagnose the disease and fight it with combinations of two or
more types of antibiotics at the same time.
This technique is used in the treatment of some other
infections like tuberculosis in an attempt to make it more
difficult for the bacteria to learn how to overcome the drugs.
If left untreated, gonorrhea can lead to pelvic inflammatory
disease, ectopic pregnancy, stillbirths, severe eye infections
in babies and infertility in both men and women.
In the United States, there are approximately 300,000
reported cases of gonorrhea each year, but because infected
people often have no symptoms, the actual number of cases is
likely closer to 700,000, Bolan said.
So-called "superbug" drug-resistant strains of gonorrhea
accounted for almost one in 10 cases of sexually transmitted
disease in Europe in 2010, more than double the rate of the year
before, health officials from the Stockholm-based European
Centre for Disease Prevention and Control said in June.
Dr. Robert Kirkcaldy of the CDC said there have so far been
no U.S. cases of "untreatable" gonorrhea, in which the germ
resists all known treatments, but U.S. laboratory data suggest
resistance is beginning to emerge.
The guidelines also recommend that healthcare providers
closely monitor their patients for treatment failure, and retest
patients with persistent symptoms with a culture-based gonorrhea
test, which can identify antibiotic-resistant infections.
Doctors said cefixime may be needed as an alternative
treatment option in some cases. If ceftriaxone is not readily
available, providers may prescribe a dual therapy of cefixime
plus one of two other antibiotics: azithromycin or doxycycline.
In addition to closely monitoring for resistance nationally,
CDC said it is working with the World Health Organization to
monitor for emerging resistance on the global level.
The agency is also collaborating with the National
Institutes of Health to test new combinations of existing drugs.