kevin-fenton_web.jpgThe Centers for Disease Control and Prevention (CDC) has announced that it no longer recommends the oral antibiotic cefixime for the treatment of gonorrhea, due to recent laboratory data showing that the drug is becoming less effective against the disease. 

This change leaves only one drug proven effective for treating gonorrhea, the injectable antibiotic ceftriaxone.  The new gonorrhea treatment guidelines are published in CDC’s Morbidity and Mortality Weekly Report.

Gonorrhea has eventually grown resistant to every drug used to treat it. Since 2007 only one class of antibiotics –cephalosporins, which includes the drugscefixime and ceftriaxone – has been recommended. 

700,000 PER YEAR

CDC issued the new guidelines out of concern that continued use of cefixime may prompt gonorrhea to develop resistance to all cephalosporins. Limiting its use now, officials reason, may help preserve ceftriaxone as a treatment option for a little longer. 

Gonorrhea is one of the most common STDs in the United States; more than 700,000 infections are estimated to occur in this country each year.  Although some men and women may have symptoms (such as burning when urinating or discharge), most people do not.  As a result, many infections go undetected and untreated.  Left untreated, gonorrhea can cause serious health problems, particularly for women, including chronic pelvic pain, life-threatening ectopic pregnancy and even infertility.  Infection also increases the risk of contracting and transmitting HIV.

It is critical for individuals to take steps to protect themselves from infection.  The surest way to prevent infection is not having sex.  For those who are sexually active, consistent and correct condom use and limiting the number of sex partners are effective strategies for reducing the risk of infection.


 “As cefixime is losing its effectiveness as a treatment for gonorrhea infections, this change is a critical pre-emptive strike to preserve ceftriaxone, our last proven treatment option,” said Kevin Fenton, director of the CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention. 

“Changing how we treat infections now may buy the time needed to develop new treatment options.”

To guard against the threat of drug resistance, the guidelines outline additional follow-up steps providers should take to closely monitor for ceftriaxone treatment failure. According to the new recommendations, 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 retreatment for another culture test – called a test-of-cure – to ensure the infection is fully cured.

The CDC  has published a public health response plan, to keep a watchful eye on the emergence of drug resistance.

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Photo: Kevin Fenton