Local health officials are updating their gonorrhea prevention strategies following stark new findings released by the U.S. Centers for Disease Control and Prevention detailing the sexually transmitted infection’s increasing resistance to commonly prescribed antibiotics.
Healthcare providers have been urged to start using a more powerful drug and strict post-treatment testing in an effort to control the STI, according to the CDC findings released Aug. 10. The CDC reports that new cases of the disease have risen to an estimated 700,000 each year in the U.S. Less than half of those are reported to the CDC.
Due to widespread use — and at times, misuse –the disease has developed resistance to every recommended antibiotic used for the treatment of Neisseria gonorrhoeae, the bacterium that causes gonorrhea. Worse yet, the bacterium has shown signs of resistance to one of two commonly-prescribed cephalosporins, Suprax (cefixime), in CDC laboratory testing. The agency worries that continued usage of the drug could result in the bacterium’s resistance to all cephalosporins, including the alternative treatment option, Rocephin (ceftriaxone).
Although the injectable antibiotic Rocephin, which must be administered by a healthcare provider, has been proven to continue to combat the disease, the CDC is recommending a combination of treatments — the intramuscular injection of Rocephin, with one of the two oral treatments. The two recommended options for the oral treatments include Zithromax or doxycycline.
Daniel Pohl, Director of HIV/STI Prevention at Howard Brown Health Center, a local LGBT healthcare provider, said that the disease’s resistance to oral medications could be due to a variety of factors. One such cause could be due to inadvertent misuse of medications.
“If we wanted to be more conservative, people who are diagnosed would refrain from sexual activity for about a month after treatment for the disease,” Pohl said.
Gonorrhea is a disease that can rear its head in a variety of ways. Symptoms can be discovered in the penis, vagina, throat and rectum. More often than not, there are no symptoms while the infection manifests in a 2-3 week incubation period.
“We have adopted the new STD treatment recommendations from the CDC, that more effectively treats gonorrhea to delay the emergence of drug resistant strains,” said Efrat Stein, Director of Public Affairs for the City of Chicago Department of Public Health. “Our strategy is to continue to track and monitor through surveillance the emergence of drug resistant gonorrhea that we are seeing in other parts of the world.”
The CDC released information to change treatment options as far back as 2010. That was when the staff at HBHC changed their treatment regimen to combine the oral and intra-muscular injections of antibiotics simultaneously.
“We’d like to put sexual health into a more holistic framework, including education around issues that have and are changing,” said Pohl. HBHC is currently working on ways to educate the community about general sexual health. The city’s Department of Public Health also says that they are working on a public education strategy which is set to begin within the next month.
The CDC also gives recommendations for how a case of gonorrhea should be handled during and after treatment, “… patients who have persistent symptoms should be retested with a culture-based gonorrhea test, which can identify antibiotic-resistant infections. The patient should return one week after re-treatment for another culture test — called a test-of-cure — to ensure the infection is fully cured.”
As the majority of cases crop up on the West Coast among men who have sex with men, Pohl says that one major way to combat exposure is of course condom use — but also to adhere to a comprehensive screening at least twice a year.
“Addressing sexual health with a center like Howard Brown can go a long way to keep Chicago residents healthy and happy,” said Pohl.