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New alternatives examined for treating gonorrhea

8:46 PM, Jul 15, 2013   |    comments
Research continues to find treatment for gonorrhea.(Photo: Centers for Disease Control and Prevention)
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By Lindsay Friedman , USA TODAY

With a dwindling arsenal of effective treatments, physicians have worked together to add two more weapons in the fight against gonorrhea, a common sexually transmitted disease that has become resistant to a primary antibiotic method used to treat it.

Federal researchers this week will announce the result of a trial of the new treatments at an international conference on sexually transmitted diseases in Vienna.

The clinical trial, funded and conducted by the Centers for Disease Control and Prevention and the National Institute of Allergy and Infectious Diseases, included 401 infected men and women ages 15-60, who were given two different combinations of injectable and oral antibiotics widely available in the USA. Results showed a 100% rate of effectiveness in one combination of antibiotics (injectable gentamicin with oral azithromycin) and a 99.5% rate of success in the other (oral gemifloxacin with oral azithromycin). Both solutions cured infections in the throat and rectum 100% of the time.

"This is a very encouraging development in a discouraging field with very few new options in the pipeline," says Robert Kirkcaldy, the study's leading specialist and a medical epidemiologist at the CDC's division of STD prevention. "We are moving in the right direction with encouraging results."

Previously, doctors had only one form of treatment for gonorrhea, the oral antibiotic cefixime and injectable antibiotic ceftriaxone. However, the antibiotics were becoming less effective as the bacteria continued to mutate, leaving physicians with no other option to treat the most common sexually transmitted infection in the USA.

"It's very scary when you have only one effective regimen," says Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.

According to the CDC, the scenario is becoming more common because of the rapid growth of antibiotic-resistant infections such as gonorrhea. Because of these mutations, infections are more easily spread and more expensive and difficult to treat. Which is why it's one of the more concerning problems for the world of health care and the CDC, whose researchers are making it a top priority to supply alternative treatments and long-term solutions, Kirkcaldy says.

Fauci says that while the new treatments are an exciting addition that are just as effective as the previously used treatment and similar in cost, they are a bit more toxic, producing mild side effects in the majority of patients. Most side effects were gastrointestinal. For now, Kirkcaldy says the CDC will keep the current recommended treatment in place, listing the newer combinations as a valuable alternative if needed, as they continue to search for other options.

"Although it's not a game-changer," Kirkcaldy says, "it does provide valuable fallback options."

Anticipating possible mutations in the future as well, specialists say the new treatments will help them find more effective solutions that aim to prevent the infection altogether. The drug would be an improvement beyond other prevention techniques such as abstinence, condom use or STD testing. It may even help physicians find a way to test already infected patients to see which treatment they are immune to and determine the best course of action, Fauci says.

"For the future, it means we've accomplished something," he says. "It isn't the end of the road, but it's very gratifying to know we developed new treatment options ... we need to stay ahead of resistant gonorrhea infections."

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