August 10, 2012 — Physicians should stop using the oral antibiotic cefixime for routine cases of gonorrhea because it is becoming less effective, according to new guidelines published Thursday in CDC's Morbidity and Mortality Weekly Report, CQ HealthBeat reports.
While the drug has been used successfully for years in the U.S., gonorrhea samples taken from the Western U.S. and from men who have sex with men have shown resistance to the treatment (Norman, CQ HealthBeat, 8/9). Although no cases of treatment failure have been reported in the U.S., antibiotic-resistant gonorrhea strains have been found in Asia and Europe, CDC officials noted (Wetzstein, Washington Times, 8/9).
The new guidelines mean there is only one recommended treatment for gonorrhea, one of the most common sexually transmitted infections in the U.S. (Reuters/Washington Post, 8/10). Instead of cefixime, marketed under the brand name Suprax, patients should take the injectable antibiotic ceftriaxone, marketed under the brand name Rocephin, according to CDC. The guidelines also call on physicians to monitor patients closely for signs of resistance (McKay, "Health Blog," Wall Street Journal, 8/9).
There were 300,000 reported gonorrhea cases in 2010 in the U.S., though CDC estimates the actual caseload to be 700,000 annually (CQ HealthBeat, 8/9). If left untreated, the infection can cause serious complications, including infertility and ectopic pregnancy (Stein, "Shots," NPR, 8/9).
CDC officials said the recommendation is a "pre-emptive strike" to preserve one of gonorrhea's last available treatment options (CQ HealthBeat, 8/9). Gail Bolan, director of the STD prevention division at CDC, said the new recommendations "may buy us time" to discover a new class of anti-gonorrhea drugs (Washington Times, 8/9).
"Currently there is just one promising new gonorrhea drug in the pipeline and only one clinical trial is under way to examine treatment options for gonorrhea using new combinations of existing drugs," Bolan said. She added, "Multiple drugs will need to be studied to find a few that are safe and effective."
The National Institute for Allergy and Infectious Disease is funding more than 100 research grants on new treatments and a possible vaccine for gonorrhea (CQ HealthBeat, 8/9).