Gonorrhoea resistant to more medicines, New Zealand doctors warned

Gonorrhoea resistant to more medicines, New Zealand doctors warned

While gonorrhoea rates are on the up, the number of medicines available to treat the sexually transmitted infection are quickly dwindling. 

Research from the Auckland Regional Sexual Health Service and Auckland City Hospital found that while the current recommended antibiotic combination was still suitable, it was also at risk.

The bacterium that causes gonorrhoea, neisseria gonorrhoea, has became resistant to many types of antibiotics, prompting Auckland researchers to warn clinicians against becoming complacent in their treatment in a journal article published in the New Zealand Medical Journal on Friday. 

A survey of nearly 2000 patients showed resistance rates to certain antibiotics commonly used in New Zealand were too high for them to remain reliable treatments. 

The research, led by microbiologist Dr Gary McAuliffe, set out to identify antimicrobial resistance patterns for gonorrhoea in the Auckland region between 2008-16, to help them be better informed on the current approach to treatment and surveillance

Gonorrhoea is treated with antibiotics and in most cases a single dose of an injection called ceftriaxone and tablets called azithromycin usually cures it. 

But left untreated, it can cause serious and permanent health problems in both men and women, including pelvic inflammatory disease, ectopic pregnancy, infertility in women and sterility in men. 

It can also be passed from mother to baby, causing neonatal eye disease -  which is becoming increasingly common as more treatments fail. 

Results from 1941 patients were analysed, 74 per cent of which were men. 

The study showed that while ceftriaxone was still suitable for gonorrhoea treatment, other drugs were quickly losing efficacy. 

In 2016, 22 per cent of samples (53) were resistant to ciprofloxacin, 7 per cent (17) to penicillin, 31 per cent (76) to tetracycline and 0.8% (2) exhibited decreased susceptibility to ceftriaxone.

Resistance to ciprofloxacin increased "exponentially" from less than 5 per cent to 40 per cent between 2000 and 2011, due to resistant strains making their way to New Zealand from overseas.

Despite this, resistance rates for all antibiotics declined from 2013-16, they found.

Resistance to azithromycin, one of the two main antibiotics given for gonorrhoea, was also an "emerging issue". 

Researchers highlighted the need for ongoing vigilance around antimicrobial resistance through real-time results, and the introduction of susceptibility testing.  

In the future, this could mean rapid, individualised therapy for patients with STIs, they said. 

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