Condom use cuts the risk of catching a sexually transmitted disease The growing resistance to antibiotics threatens to make gonorrhoea extremely difficult to treat, a Health Protection Agency official has warned. Current drugs are still effective but signs of emerging resistance mean treatments may soon need to be revised, Professor Catherine Ison says. It could mean multiple-dose treatments instead of single doses, she says. Gonorrhoea is the second most common bacterial sexually transmitted infection in the UK. Professor Ison says there is a very real possibility that strains of gonorrhoea-causing bacteria that are resistant to all current treatment options could emerge in the near future. She has raised the issue at the Society for General Microbiology's spring meeting in Edinburgh. Pregnancy risk The Health Protection Agency has been keeping a close watch on antibiotic resistance among strains of gonorrhoea for some time and says there is an urgent need for the development of new treatments. If left untreated, gonorrhoea can lead to pelvic inflammatory disease, and women can become infertile or have ectopic pregnancies. If this problem isn't addressed then there is a real possibility that gonorrhoea will become a very difficult infection to treat

Professor Catherine Ison, Health Protection Agency The current treatment to use is either ceftriaxone or cefixime. These antibiotics are administered as a single dose. Professor Ison said: "Choosing an effective antibiotic can be a challenge because the organism that causes gonorrhoea is very versatile and develops resistance to antibiotics very quickly. "Penicillin was used for many years until it was no longer effective and a number of other agents have been used since. "The current drugs of choice, ceftriaxone and cefixime, are still very effective but there are signs that resistance, particularly to cefixime, is emerging and soon these drugs may not be a good choice." Bad news She added: "There are few new drugs available and so it is probable that the current use of a single dose may soon need to be revised and treatment over several days or with more than one antibiotic will need to be considered. "If this problem isn't addressed then there is a real possibility that gonorrhoea will become a very difficult infection to treat." Hugh Pennington, emeritus professor of bacteriology at Aberdeen University, said it would be bad news from a public health point of view if people had to be given several doses. Whilst recognising that this might prove necessary, he said the downside was that some patients would not go back to a clinic for later treatments and so would not get rid of the infection. "This could make resistance, which could lead to a superbug situation," he said. The Health Protection Agency says there is no need to change treatment at the moment, but it is important for doctors to be vigilant. It says the high number of cases of sexually transmitted infections (STIs) such as gonorrhoea reinforces the need for people to use condoms with new and casual partners. Jason Warriner, Clinical Director at Terrence Higgins Trust, said: "As levels of STIs continue to rise, we will see drug-resistant strains develop. This just shows how crucial it is for those who have been at risk to go for regular sexual health check-ups. "We recommend people who are sexually active get checked out at least once a year. Most modern tests involve a simple urine sample or self-administered swab. They are quick, easy, and a good way to achieve peace of mind."



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