New Drug-Resistant Gonorrhea Strain Identified in US: What to Know

When symptoms are present, they may vary from person to person, depending on the area that’s infected; gonorrhea symptoms can also be mistaken for other common health issues, like a urinary tract infection. These are the most common signs to be aware of, per the CDC: Painful or burning sensation when peeingIncreased vaginal dischargeWhite, yellow, or green discharge from the penisVaginal bleeding between periodsPainful or swollen testiclesAnal itching, discharge, soreness/pain, or bleedingThe rise of drug-resistant gonorrhea doesn’t mean there are no treatments available—but the options are limited.Gonorrhea used to be treated with a class of antibiotics called fluoroquinolones, but is now primarily treated with cephalosporins (which include the aforementioned ceftriaxone). Currently, the primary treatment for gonorrhea is a single, 500-milligram injection of ceftriaxone, and, because reinfection is common, the CDC recommends being retested three months after treatment. So far, ceftriaxone has been an effective cure for the strains of gonorrhea that have been detected in the US, Thomas Russo, MD, a professor and the chief of infectious diseases at the University at Buffalo in New York.If that initial injection of ceftriaxone doesn’t beat the bacteria, a doctor should prescribe a higher dose, potentially with another “second-line” antibiotic, Dr. Russo says. “This is why culture and susceptibility testing is important,” he explains. “It may identify alternatives.”However, the CDC warns that if a strain of gonorrhea that’s resistant to cephalosporins eventually emerges, it would “significantly complicate” our ability to treat the STI successfully—there are few antibiotic options left that are “simple, well-studied, well-tolerated, and highly effective” against the bacteria. That doesn’t mean we suddenly have no options, but it does mean that our options are becoming limited. Experts are studying the efficacy of new drugs to treat gonorrhea, but they may take years to reach the market. And quick, effective treatment is pretty crucial: Untreated gonorrhea can potentially lead to serious complications for some people, including pelvic inflammatory disease, an infection of the uterus, fallopian tubes, or ovaries that can raise a person’s risk of infertility, according to Dr. Russo. In rare cases, untreated gonorrhea can also become life-threatening if the infection spreads to your bloodstream or joints.The best way to avoid any issues that gonorrhea may give you is to try to avoid the STI in the first place—which, of course, is up to both you and your sexual partner(s). This starts with having open, honest communication about sex. Using a barrier method (like a condom, diaphragm, or dental dam) correctly will help reduce your risk of contracting or spreading various STIs (again, you or your partner(s) may not even be aware that you have an infection, so using protection is important even if you don’t have symptoms). Dr. Adalja also says it’s “critical” for any sexually active person to get tested for STIs regularly to ensure early detection; the CDC recommends at least once a year for gonorrhea, syphilis, and chlamydia, or more frequently—at least every three to six months—if you recently had sex with a new partner or multiple partners. If you’re not totally sure how often you should get tested, don’t hesitate to bring it up with your doctor. (You can find an STI testing site in your area here, or you can visit your local Planned Parenthood for these services.)If you happen to develop any symptoms that feel out of your norm—pain, discharge, just a general feeling that something is “off”—don’t wait to see your primary care doctor, ob-gyn, or even a provider at your urgent care clinic, Dr. Russo says: “Fast and effective treatment is important.”Related:

When symptoms are present, they may vary from person to person, depending on the area that’s infected; gonorrhea symptoms can also be mistaken for other common health issues, like a urinary tract infection. These are the most common signs to be aware of, per the CDC

  • Painful or burning sensation when peeing
  • Increased vaginal discharge
  • White, yellow, or green discharge from the penis
  • Vaginal bleeding between periods
  • Painful or swollen testicles
  • Anal itching, discharge, soreness/pain, or bleeding

The rise of drug-resistant gonorrhea doesn’t mean there are no treatments available—but the options are limited.

Gonorrhea used to be treated with a class of antibiotics called fluoroquinolones, but is now primarily treated with cephalosporins (which include the aforementioned ceftriaxone). Currently, the primary treatment for gonorrhea is a single, 500-milligram injection of ceftriaxone, and, because reinfection is common, the CDC recommends being retested three months after treatment. So far, ceftriaxone has been an effective cure for the strains of gonorrhea that have been detected in the US, Thomas Russo, MD, a professor and the chief of infectious diseases at the University at Buffalo in New York.

If that initial injection of ceftriaxone doesn’t beat the bacteria, a doctor should prescribe a higher dose, potentially with another “second-line” antibiotic, Dr. Russo says. “This is why culture and susceptibility testing is important,” he explains. “It may identify alternatives.”

However, the CDC warns that if a strain of gonorrhea that’s resistant to cephalosporins eventually emerges, it would “significantly complicate” our ability to treat the STI successfully—there are few antibiotic options left that are “simple, well-studied, well-tolerated, and highly effective” against the bacteria. That doesn’t mean we suddenly have no options, but it does mean that our options are becoming limited. Experts are studying the efficacy of new drugs to treat gonorrhea, but they may take years to reach the market. And quick, effective treatment is pretty crucial: Untreated gonorrhea can potentially lead to serious complications for some people, including pelvic inflammatory disease, an infection of the uterus, fallopian tubes, or ovaries that can raise a person’s risk of infertility, according to Dr. Russo. In rare cases, untreated gonorrhea can also become life-threatening if the infection spreads to your bloodstream or joints.

The best way to avoid any issues that gonorrhea may give you is to try to avoid the STI in the first place—which, of course, is up to both you and your sexual partner(s). This starts with having open, honest communication about sex. Using a barrier method (like a condom, diaphragm, or dental dam) correctly will help reduce your risk of contracting or spreading various STIs (again, you or your partner(s) may not even be aware that you have an infection, so using protection is important even if you don’t have symptoms). 

Dr. Adalja also says it’s “critical” for any sexually active person to get tested for STIs regularly to ensure early detection; the CDC recommends at least once a year for gonorrhea, syphilis, and chlamydia, or more frequently—at least every three to six months—if you recently had sex with a new partner or multiple partners. If you’re not totally sure how often you should get tested, don’t hesitate to bring it up with your doctor. (You can find an STI testing site in your area here, or you can visit your local Planned Parenthood for these services.)

If you happen to develop any symptoms that feel out of your norm—pain, discharge, just a general feeling that something is “off”—don’t wait to see your primary care doctor, ob-gyn, or even a provider at your urgent care clinic, Dr. Russo says: “Fast and effective treatment is important.”

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