UK doctors have been told to stop using the antibiotic cefixime to treat gonorrhoea, as the sexually transmitted infection has become increasingly resistant to the drug. Cefixime has been the first choice drug used to treat gonorrhoea for the past ten years, but a report from the Health Protection Agency now recommends using a combination of two other antibiotics - ceftriaxone and azithromycin - to cure the infection. Ceftraxone is given as an injection and azithromycin is taken orally. The report details how tests on bacteria samples taken from patients and grown in the laboratory showed 'reduced susceptibility' or resistance to cefixime in 17.4 percent of cases in 2010, compared with 10.6 per cent of cases in 2009, the report stated. As recently as 2005, no gonorrhoea bacteria with resistance to cefixime were identified in the UK. After chlamydia, gonorrhoea is the second most common bacterial sexually transmitted infection in the UK. Since the discovery of penicillin more than 70 years ago, gonorrhoea has been easily treatable by doctors. However, the bacterium behind the infection - Neisseria gonorrhoeae - has an unusual ability to adapt itself and has increasingly become resistant to the antibiotics used to treat gonorrhoea - first penicillin itself, then tetracyclines, ciprofloxacin and now cefixime. The World Health Organization recommends that the first-line antibiotic used is changed when treatment failure in patients reaches five per cent. But for cefixime, the change is being made pre-emptively, owing to the alarming rise in reduced susceptibility in lab tests, which is an early indicator of developing resistance. Professor Cathy Ison, a gonorrhoea expert at the HPA, said: "Our lab tests have shown a dramatic reduction in the sensitivity of the drug we were using as the main treatment for gonorrhoea. This presents the very real threat of untreatable gonorrhoea in the future. "We were so worried by the results we were seeing that we recommended that guidelines on the treatment of gonorrhoea were revised in May this year, to recommend a more effective drug. "But this won’t solve the problem, as history tells us that resistance to this therapy will develop too. In the absence of any new alternative treatments for when this happens, we will face a situation where gonorrhoea cannot be cured. "Many patients may feel anxious about having an injection, but this is now the best way of avoiding treatment failure. Patients who refuse the jab will be offered oral antibiotics instead. "This highlights the importance of practising safe sex, as, if new antibiotic treatments can’t be found, this will be only way of controlling this infection in the future." Jason Warriner, clinical director of the Terrence Higgins Trust, added: "It’s worrying that gonorrhoea has developed resistance to certain drugs in a relatively short period of time. "Gonorrhoea doesn't always present symptoms so it's vital that people and their partners have regular screenings for it, alongside other sexually transmitted infections (STIs) in order to get treated at the earliest possible stage. The only way to prevent STIs is to use condoms. "Anyone worried they have put themselves at risk should book in a quick and easy test with their local sexual health clinic."
IMHO, this is rather old news; the US has been treating GC with Rocephin - Zithromax (ceftriaxone - azithromycin) as a first line drug of choice for years. Given the ease of travel nowadays, the UK probably should have done the same years ago.
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