Antibiotics may soon be ineffective against gonorrhea, chlamydia, syphilis

August 31, 2016

The World Health Organization (WHO) has recently issued new treatment guidelines for three common sexually-transmitted infections (STIs) as a response to the rising threat of antibiotic resistance.

Chlamydia, gonorrhea and syphilis are all generally caused by bacteria and treatable with antibiotics. According to estimates, 131 million people are infected with chlamydia, 78 million with gonorrhea, and 5.6 million with syphilis each year.

Gonorrhea is a common STI that can cause infection in the genitals, rectum, and throat. Syphilis is spread by contact with a sore on the genitals, anus, rectum, lips or mouth, or from mother to child during pregnancy.Chlamydia is the most common bacterial STI and people with this infection are frequently co-infected with gonorrhoea. Symptoms of chlamydia include discharge and a burning feeling when urinating, but most people who are infected have no symptoms.

But these infections usually go undiagnosed and as a result, they are becoming more difficult to treat. Some antibiotics are even failing to treat these infections because of overuse and misuse.

In recent years, the resistance of chlamydia, gonorrhea and syphilis to antibiotics has rapidly increased and this has reduced treatment options.

Gonorrhea shows the strongest resistance to antibiotics among the three. Multidrug-resistant gonorrhea strains that do not respond to any available antibiotics have been detected. The resistance to antibiotics in chlamydia and syphilis also already exists, although they are less common. These recent developments emphasize the importance of prevention and prompt clinical treatment.

If left undiagnosed and untreated, these STIs can eventually cause serious complications and long-term health problems for women, including pelvic inflammatory disease, ectopic pregnancy, and miscarriage. Any untreated STI in a pregnant woman raises the chances of newborn death or stillbirth.

If gonorrhea is left untreated, it could cause infertility to both men and women. A person’s risk of being infected with HIV may also increase by two- or three-fold if they are infected with gonorrhea, chlamydia or syphilis.

“Chlamydia, gonorrhea and syphilis are major public health problems worldwide, affecting millions of peoples’ quality of life, causing serious illness and sometimes death. The new WHO guidelines reinforce the need to treat these STIs with the right antibiotic, at the right dose, and the right time to reduce their spread and improve sexual and reproductive health. To do that, national health services need to monitor the patterns of antibiotic resistance in these infections within their countries,” says Ian Askew, Director of Reproductive Health and Research, WHO.

The new recommendations are based on the latest available evidence on the most effective treatments for these three sexually-transmitted infections.

In response to the growing antibiotic resistance threat, countries are urged by the WHO to update their guidelines on gonorrhea. Health authorities are called on to advise their doctors to prescribe whichever antibiotic is most effective, based on local resistance patterns.

“The new WHO guidelines do not recommend quinolones (a class of antibiotic) for the treatment of gonorrhea due to widespread high levels of resistance,” WHO said in its statement.

To cure syphilis, the new WHO guidelines strongly recommend a single dose of benzathine penicillin – a form of the antibiotic that is injected by a doctor or nurse into the infected patient’s buttock or thigh muscle. This is the most effective treatment for syphilis, as it is more effective and cheaper than oral antibiotics.

In May 2016, benzathine penicillin was recognized by the Sixty-ninth World Health Assembly as an essential medicine which has been in short supply for several years.WHO is working with partners to identify countries with shortages and help monitor global availability of benzathine penicillin to close the gap between national needs and supply of the antibiotic.

For chlamydia, governments are being called on to update their guidelines based on the recommendations in “Global Health Sector Strategy for Sexually Transmitted Infections (2016-2021)” endorsed by governments at the World Health Assembly in May 2016.

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