About Careers Internship MedBlog Contact us

The Fight Against Antimicrobial-Resistant Gonorrhea

by Bidita Debnath on November 2, 2017 at 12:00 AM
The Fight Against Antimicrobial-Resistant Gonorrhea

Gonorrhea is a sexually transmitted disease (STD) caused by the bacteria N. gonorrhoeae. A previously recommended treatment for gonorrhea, cefixime, may be an effective alternative to current treatments as clinicians battle outbreaks and emergence of antimicrobial resistance (AMR).

This is according to a study published this week by Xavier Didelot of Imperial College London, UK, and colleagues in PLOS Medicine. Gonorrhea is one of the most common sexually transmitted infections in England, and incidence has increased in recent years, particularly among men who have sex with men (MSM). Treating gonorrhea is complicated by the rapid development of antimicrobial resistance (AMR). The cephalosporin antibiotic cefixime was a recommended first-line treatment for gonorrhea before increasing prevalence of cefixime-resistant strains of N. gonorrhoeae was observed around 2010, leading to the removal of cefixime from treatment guidelines. While the currently recommended dual therapy of ceftriaxone-azithromycin remains effective, emerging ceftriaxone resistance has led to fears that this regimen may in turn become inadequate.


To determine whether re-introduction of cefixime treatment in a minority of cases might provide an effective alternative and help prevent emergence of resistance to ceftriaxone-azithromycin, the researchers developed a mathematical model of the dynamics of cefixime resistance observed between 2008 and 2015. The model includes a fitness benefit of cefixime resistance in N. gonorrhoeae during periods of wide use of the antibiotic (explaining the increase in resistant strains up to 2010) and a fitness cost of resistance (explaining the decrease in cefixime resistance after 2010). The model estimates treating cefixime-resistant gonorrhea with cefixime to be unsuccessful in 83% (95% credible interval [CrI] 53%-99%) of cases, representing a fitness benefit of resistance large enough to counterbalance the fitness cost to N. gonorrhoeae when more than 31% (95% CrI 26%-36%) of cases are treated with cefixime. The authors therefore suggest that cefixime could be used to treat up to 25% of gonorrhea cases without risk of cefixime resistance re-emerging.

The authors note that epidemiological data for their model is restricted to MSM, the population in which the cefixime-resistant outbreak of gonorrhea was concentrated, and that assumptions made to keep the model simple and generalizable may impact predictions.

In an accompanying Perspective, Magnus Unemo of Orebro University Hospital, Orebro, Sweden, and Christian Althaus of the University of Bern, Switzerland, discuss the value of modelling studies to inform AMR management. They also note the limitations of the current evidence base informing such models, highlight the need for studies measuring the many factors that affect transmissibility of resistant strains, and suggest caution before widely reintroducing antimicrobials such as cefixime.

Both papers are included in the new PLOS Medicine Collection on Sexually Transmitted Infections.

Source: Eurekalert
Font : A-A+



Recommended Readings

Latest Research News

Brain Circuits That Shape Bedtime Rituals in Mice
New study sheds light on the intrinsic, yet often overlooked, role of sleep preparation as a hardwired survival strategy.
NELL-1 Protein Aids to Reduce Bone Loss in Astronauts
Microgravity-induced bone loss in space, can be reduced by systemic delivery of NELL-1, a protein required for bone growth and its maintenance.
Connecting Genetic Variants to the Alzheimer's Puzzle
Researchers establish connections between Alzheimer's-linked genetic alterations and the functioning of brain cells.
Gene Therapy Sparks Spinal Cord Regeneration
Team at NeuroRestore introduces a groundbreaking gene therapy that has effectively promoted nerve regrowth and reconnection, post spinal cord injury.
Unlocking the Gut Microbiome's Influence on Bone Density
Scientists aim to pinpoint particular functional pathways affected by these bacteria that may have an impact on skeletal health.
View All
This site uses cookies to deliver our services.By using our site, you acknowledge that you have read and understand our Cookie Policy, Privacy Policy, and our Terms of Use  Ok, Got it. Close
Greetings! How can I assist you?MediBot

The Fight Against Antimicrobial-Resistant Gonorrhea Personalised Printable Document (PDF)

Please complete this form and we'll send you a personalised information that is requested

You may use this for your own reference or forward it to your friends.

Please use the information prudently. If you are not a medical doctor please remember to consult your healthcare provider as this information is not a substitute for professional advice.

Name *

Email Address *

Country *

Areas of Interests