by Emily Ike, Research Intern

The Centers for Disease Control and Prevention (CDC) no longer recommends the oral antibiotic treatment for gonorrhea, cefixime, in response to recent laboratory data which shows that it is becoming less effective in treating the sexually transmitted disease (STD). Marketed under the brand name Suprax, this drug is one of the two last remaining effective treatments for gonorrhea, the other being the injectable antibiotic ceftriaxone.[1]

Gonorrhea has developed a drug resistance to every antibiotic that was recommended for treatment, leaving only the cephalosporins, which include cefixime and ceftriaxone, as the final effective treatment method for the sexually transmitted infection.[2]Approximately 300,000 cases of gonorrhea are reported each year in the U.S., though it is estimated that there are closer to 700,000 infections per year because of individuals who are infected but show no symptoms.[3] If left untreated gonorrhea can pose serious health problems for men, women and newborns, including: infection of the urethra, cervix and rectum; stillbirths and miscarriages; infertility in both men and women; an increased risk of contracting HIV; and severe eye infections in up to 50% of newborn infants born to women with untreated gonorrhea, which can cause blindness.[4] Women can also experience chronic pelvic pain and life-threatening ectopic pregnancies if the infection is left untreated.[5]

“Gonorrhea is becoming a major public health challenge, due to the high incidence of infections accompanied by dwindling treatment options,” says Dr. Manjula Lusti-Narasimhan, of the Department of Reproductive Health and Research at the WHO. “The available data only shows the tip of the iceberg. Without adequate surveillance we won’t know the extent of resistance to gonorrhea and without research into new antimicrobial agents, there could soon be no effective treatment for patients.”[6]

This change in antibiotic treatment guidelines is a precautionary measure in order to preserve the effectiveness of cefixime as a viable treatment option for gonorrhea. By cutting back on its usage now, health officials hope to buy more time to research new treatment options, as well as to safeguard the effectiveness of cefixime for at least a little while longer.

“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,” said Dr. Gail Bolan, Director of the CDC’s Division of STD Prevention. [7]

CDC now recommends that doctors treat patients with gonorrhea with a combination therapy including the injectable antibiotic ceftriaxone, along with one of two other oral antibiotics: azithromycin or doxycycline. Patients who have persistent symptoms should be retested with a culture-based gonorrhea test, which can identify antibiotic-resistant infections, and it is recommended that doctors perform a test-of-cure one week after treatment to keep a close eye on the emergence of drug resistant strains of this bacteria.[8]