Two antibiotic combinations show success in treating gonorrhea in clinical trials
With relatively recent reports of a “shrinking arsenal” of antibiotics to treat the sexually transmitted infection, gonorrhea, the Centers for Disease Control and Prevention (CDC) announced in a press release Monday, promising results of treatment options in clinical trials.
This Gram-stained photomicrograph reveals the presence of intracellular Gram-negative, Neisseria gonorrhoeae diplococcal bacteria, amongst numerous white blood cells (WBCs). Image/CDC
In the trial was conducted by the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH), researchers tested two new antibiotic regimens using existing drugs – injectable gentamicin in combination with oral azithromycin and oral gemifloxacin in combination with oral azithromycin, which successfully treated gonorrhea infections in a clinical trial.
The drugs studied in the trial were Food and Drug Administration-approved and are available in the United States. This is the first clinical trial to evaluate them as combination therapy for gonorrhea.
Researchers found 100 percent effectiveness of the injectable gentamicin/oral azithromycin combination in curing genital gonorrhea infections, and 99.5 percent effectiveness of the oral gemifloxacin/oral azithromycin combination.
Both combinations cured 100 percent of infections of the throat and rectum. However, many trial participants reported adverse effects from the drugs, mostly gastrointestinal issues.
“These trial results are an exciting step in the right direction in the fight against drug-resistant gonorrhea,” said Gail Bolan, M.D., director of CDC’s Division of STD Prevention. “But patients need more oral options with fewer side effects. It is imperative that researchers and pharmaceutical companies prioritize research to continue to identify new, effective, better-tolerated drugs and drug combinations.”
“In addition to developing new treatment options, additional measures to stay ahead of resistant gonorrhea are critical,” said Anthony S. Fauci, M.D., director of NIH’s National Institute of Allergy and Infectious Diseases (NIAID). “For example, a point-of-care drug susceptibility test would help providers know — at the time of diagnosis — which treatment regimen will be most effective. Progress toward a vaccine is urgently needed.”
The CDC said the announcement does not change current gonorrhea treatment guidelines. CDC still recommends only one first-line treatment regimen: injectable ceftriaxone, in combination with one of two other oral antibiotics, either azithromycin or doxycycline.
This regimen remains highly effective in treating gonorrhea and causes limited side effects. However, providers may consider using the regimens studied in this trial as alternative options when ceftriaxone cannot be used, such as in the case of a severe allergy.
Gonorrhea, which experienced a massive decline from the mid-70s to the mid-90s, has been increasing in recent years. In 2011, The CDC reported 321,849 gonorrhea infections.
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