The World Health Organisation (WHO) has warned that gonorrhoea, a common sexually-transmitted infection, is becoming impossible to treat.
In a news release Friday, the global health watchdog said the danger was posed by increasing cases of antibiotic resistance by gonorrhoea-causing bacteria.
According to the release, data from 77 countries show that antibiotic resistance is making the infection –much harder, and sometimes impossible, to treat.
"The bacteria that cause gonorrhoea are particularly smart. Every time we use a new class of antibiotics to treat the infection, the bacteria evolve to resist them," said Dr Teodora Wi, Medical Officer, Human Reproduction, at WHO.
WHO reports 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 gonorrhoea is actually more common," adds Dr Wi.
Each year, an estimated 78 million people are infected with gonorrhoea. Gonorrhoea can infect the genitals, rectum, and throat. Complications of gonorrhoea 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 this increase, said the report.
The WHO Global Gonococcal Antimicrobial Surveillance Programme (WHO GASP), data from 2009 to 2014 find widespread resistance to ciprofloxacin [97% of countries that reported data in that period found drug-resistant strains], increasing resistance to azithromycin [81%], and the emergence of resistance to the current last-resort treatment: the extended-spectrum cephalosporins (ESCs) oral cefixime or injectable ceftriaxone [66%].
Currently, in most countries, ESCs are the only single antibiotic that remain effective for treating gonorrhoea. But resistance to cefixime – and more rarely to ceftriaxone – has now been reported in more than 50 countries. As a result, WHO issued updated global treatment recommendations in 2016 advising doctors to give 2 antibiotics: ceftriaxone and azithromycin.
WHO advises that gonorrhoea can be prevented through safer sexual behaviour, in particular consistent and correct condom use. Information, education, and communication can promote and enable safer sex practices, improve people’s ability to recognise the symptoms of gonorrhoea and other sexually transmitted infections, and increase the likelihood they will seek care.
The organisation however regrets that lack of public awareness, lack of training of health workers, and stigma around sexually transmitted infections remain barriers to greater and more effective use of these interventions.
