who antibiotic resistant gonorrhoea on the rise, new drugs needed
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7/12/2017 WHO | Antibiotic‐resistant gonorrhoea on the rise, new drugs needed
http://www.who.int/mediacentre/news/releases/2017/Antibiotic‐resistant‐gonorrhoea/en/ 1/4
Media centreAntibioticresistant gonorrhoea on the rise,new drugs neededNews release
7 JULY 2017 | GENEVA Data from 77 countries show that antibioticresistance is making gonorrhoea – a common sexuallytransmittedinfection – much harder, and sometimes impossible, to treat.
"The bacteria that cause gonorrhoea are particularly smart. Every timewe use a new class of antibiotics to treat the infection, the bacteriaevolve to resist them," said Dr Teodora Wi, Medical Officer, HumanReproduction, at WHO.
WHO reports widespread resistance to older and cheaper antibiotics.Some countries – particularly highincome ones, where surveillance isbest – are finding cases of the infection that are untreatable by allknown antibiotics.
"These cases may just be the tip of the iceberg, since systems todiagnose and report untreatable infections are lacking in lowerincomecountries where gonorrhoea is actually more common," adds Dr Wi.
Each year, an estimated 78 million people are infected with gonorrhoea*.Gonorrhoea can infect the genitals, rectum, and throat. Complications ofgonorrhoea disproportionally affect women, including pelvic inflammatorydisease, ectopic pregnancy and infertility, as well as an increased riskof HIV.
Decreasing condom use, increased urbanization and travel, poorinfection detection rates, and inadequate or failed treatment allcontribute to this increase.
Monitoring drug resistance
The WHO Global Gonococcal Antimicrobial Surveillance Programme(WHO GASP), monitors trends in drugresistant gonorrhoea. WHOGASP data from 2009 to 2014 find widespread resistance tociprofloxacin [97% of countries that reported data in that period founddrugresistant strains], increasing resistance to azithromycin [81%], andthe emergence of resistance to the current lastresort treatment: theextendedspectrum cephalosporins (ESCs) oral cefixime or injectableceftriaxone [66%].
Currently, in most countries, ESCs are the only single antibiotic thatremain effective for treating gonorrhoea. But resistance to cefixime –and more rarely to ceftriaxone – has now been reported in more than 50
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countries. As a result, WHO issued updated global treatmentrecommendations in 2016 advising doctors to give 2 antibiotics:ceftriaxone and azithromycin.
Development of new drugs
The R&D pipeline for gonorrhoea is relatively empty, with only 3 newcandidate drugs in various stages of clinical development:solithromycin, for which a phase III trial has recently been completed;zoliflodacin, which has completed a phase II trial; and gepotidacin,which has also completed a phase II trial.
The development of new antibiotics is not very attractive for commercialpharmaceutical companies. Treatments are taken only for short periodsof time (unlike medicines for chronic diseases) and they become lesseffective as resistance develops, meaning that the supply of new drugsconstantly needs to be replenished.
The Drugs for Neglected Diseases initiative (DNDi) and WHO havelaunched the Global Antibiotic Research and Development Partnership(GARDP), a notforprofit research and development organization,hosted by DNDi, to address this issue. GARDP’s mission is to developnew antibiotic treatments and promote appropriate use, so that theyremain effective for as long as possible, while ensuring access for all inneed. One of GARDP’s key priorities is the development of newantibiotic treatments for gonorrhoea.
"To address the pressing need for new treatments for gonorrhoea, weurgently need to seize the opportunities we have with existing drugs andcandidates in the pipeline. In the short term, we aim to accelerate thedevelopment and introduction of at least one of these pipeline drugs,and will evaluate the possible development of combination treatmentsfor public health use," said Dr Manica Balasegaram, GARDP Director."Any new treatment developed should be accessible to everyone whoneeds it, while ensuring it’s used appropriately, so that drug resistanceis slowed as much as possible."
Gonorrhoea prevention
Gonorrhoea can be prevented through safer sexual behaviour, inparticular consistent and correct condom use. Information, education,and communication can promote and enable safer sex practices,improve people’s ability to recognize the symptoms of gonorrhoea andother sexually transmitted infections, and increase the likelihood theywill seek care. Today, lack of public awareness, lack of training ofhealth workers, and stigma around sexually transmitted infectionsremain barriers to greater and more effective use of these interventions.
There are no affordable, rapid, pointofcare diagnostic tests forgonorrhoea. Many people who are infected with gonorrhoea do not haveany symptoms, so they go undiagnosed and untreated. On the otherhand, however, when patients do have symptoms, such as dischargefrom the urethra or the vagina, doctors often assume it is gonorrhoeaand prescribe antibiotics – even though people may be suffering fromanother kind of infection. The overall inappropriate use of antibiotics
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increases the development of antibiotic resistance in gonorrhoea as wellas other bacterial diseases.
“To control gonorrhoea, we need new tools and systems for betterprevention, treatment, earlier diagnosis, and more complete tracking andreporting of new infections, antibiotic use, resistance and treatmentfailures,” said Dr Marc Sprenger, Director of Antimicrobial Resistance atWHO. “Specifically, we need new antibiotics, as well as rapid, accurate,pointofcare diagnostic tests – ideally, ones that can predict whichantibiotics will work on that particular infection – and longer term, avaccine to prevent gonorrhoea.”
Notes to editors
This press release is based on two papers included in a specialsupplement of PLOS Medicine to be published just before the STI & HIVWorld Congress (http://www.stihivrio2017.com) taking place in Rio deJaneiro, Brazil, 9–12 July 2017:
Antimicrobial resistance in Neisseria gonorrhoeae: Global surveillanceand a call for international collaborative actionLead author: Dr Teodora Wi, WHO, Department of ReproductiveHealthMultidrugresistant gonorrhoea: A research and development roadmapto discover new medicines (PDF)Lead author: Dr Emilie Alirol, GARDP/DNDi
At the STI & HIV World Congress, WHO will host a session on “Tacklingantimicrobial resistance in Neisseria gonorrhoeae: Need for acomprehensive and collaborative approach”.
More about gonorrhoea
Global Antibiotic Research and Development Partnership (GARDP)Global Action Plan on Antimicrobial Resistance
* Each year, an estimated 35.2 million people are infected in the WHOWestern Pacific Region, 11.4 million people in the WHO SouthEastAsian Region, 11.4 million in the WHO African Region, 11.0 million inthe WHO Region of the Americas, 4.7 million in the WHO EuropeanRegion and 4.5 million in the WHO Eastern Mediterranean Region.
For more information, please contact:
Tarik JašarevićCommunications Officer, WHOTelephone: +41 22 791 5099Mobile: +41 793 676 214Email: [email protected]
Kimberly Chriscaden Communications Officer, WHOTelephone: +41 22 791 2885Mobile: +41 79 603 1891Email: [email protected]
7/12/2017 WHO | Antibiotic‐resistant gonorrhoea on the rise, new drugs needed
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Ilan MossSenior Communications Manager, DNDi (North America)Telephone: + 1 646 616 8681Mobile: +1 646 266 5216Email: [email protected]
Jo KuperDNDi (Geneva)Telephone: +41 22 907 7721Mobile: +41 79 128 5241Email: [email protected]
Recent surveillance andresearch
Antimicrobial resistance inNeisseria gonorrhoeae: Globalsurveillance and a call forinternational collaborativeactionMultidrugresistant gonorrhoea:A research and developmentroadmap to discover newmedicines (PDF)
More about gonorrhoea
WHO guidelines for thetreatment of NeisseriagonorrhoeaeScientists warn that antibioticresistant gonorrhoea is on theriseGlobal action plan on AMRGlobal Antibiotic Research andDevelopment Partnership(GARDP)
Press briefing
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