Antibiotics-resistant gonorrhea has become a dangerous perspectives in the United States, causing concern that humans can one day live with sexually transmitted bacteria.
But now there is reason to hope. A newly developed antibiotic tablet has been shown to be effective against gonorrhea in early clinical trials.
Zoliflodacin has proven to be effective in the treatment of gonorrhea of urinary and genital tract and rectum infections, researchers say.
"Gonoreja has become resistant to any antibiotic that has ever been used for it, so we are right now on our latest class of antibiotic that can be used," said lead researcher Dr. Stephanie Tailor, a specialist in infectious diseases in Nev Orleans.
"This is very, very encouraging as a potential new antibiotic," added Tailor, the medical director of the Louisiana State Universiti-CrescentCare Center for Sexual Health.
The results of the study were published on November 8th New England Journal of Medicine.
The rates of gonorrhea have increased dramatically in recent years in the United States.
More than 555,600 cases were reported nationally in 2017, an increase of 18% over the previous year, said Dr. Susan Blank, Assistant Commissioner for the Department of Health and Mental Hygiene in New York. And between 2013 and 2017, the rate of gonorrhea increased by 67%.
"It's a fast-growing infection in the United States," Blank said. "We see a fairly rapid increase, it's rarely fatal, but it can really have a profound impact on the quality of life."
Currently, people with gonorrhea are treated by injection of ceftriaxone, the only antibiotic still effective against bacteria, Tailor said.
"We know that gonorrhea has incredible capacity to develop resistance to antibiotics," Blank said. "Where we are right now, a gonorrhea that can not be created is a real possibility."
Unhealed gonorrhea can cause sterility in humans, as well as inflammatory carcinoma, ectopic pregnancy and destructive arthritis, Blank said. Babies infected with mothers exposed to gonorrhea may be blind.
"Gonorrhea also greatly facilitates the transmission of an HIV infection between sexual partners," Blank said, written by an editorial board that follows the new trial results.
It's hard to heal
In this clinical trial of 141 participants, zoliflodacin proved to be almost as effective as ceftriaxone.
Zoliflodacin cured 96% of genital and urinary tract infections and 100% rectal infections, compared with 100% ceftriaxone effect, researchers report.
The new antibiotic has fought gonorrhea in the throat, with a larger dose of 3 grams, which makes up only 82% of the infections compared to the effect of 100% of ceftriaxone.
"It's a historical way the throat gonor has reacted," Tailor said. "It was always hard to treat."
The most common side effects were gastrointestinal, and none of the patients asked for the cancellation of new drugs, said Tailor. One restriction was that only 12 women participated in the trial.
This is the second of the three clinical trials required for the approval of zoliflodacin in the United States. Phase 3 trials begin next year, Tailor said. If such trials are going well, the US Food and Drug Administration will have the data available to assess and approve the antibiotic by 2020. The agency has already approved the antibiotic label "fast track".
Although the development of zoliflodacin is encouraging, more antibiotics need to be developed to counteract gonorrhea and other antibiotic-resistant bacteria, Tailor and Blank said.
"Even if this antibiotic is perfect, we know that gonorrhea will outsmart," said Blank. "We need things in the back pocket, we do not know how quickly it will outsmart."
Doctors and health workers also need to continue their efforts to discover and treat gonorrhea, Blank said. People who are sexually active should use condoms to prevent the transmission of gonorrhea, which disproportionately spreads among blacks, Latino Americans and Indians.
"Controlling gonorrhea in the population requires a whole series of related activities," Blank said.
The clinical trial was partly funded by zoliflodacin co-developer Entasis Therapeutics, spinoff AstraZeneca.