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Gonorrhoea drug resistance prompts action plan

WebMD UK Health News
Medically Reviewed by Dr Rob Hicks
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27th February 2013 - Increasing evidence that gonorrhoea is becoming resistant to treatment with antibiotics has prompted calls for a heightened response throughout England and Wales to combat a "serious threat".

The Health Protection Agency (HPA) has launched the first Gonorrhoea Resistance Action Plan to help manage the disease in the absence of any new treatments.

Gonorrhoea is the second most common bacterial sexually transmitted infection (STI) in England. In

2011, new diagnoses rose to nearly 21,000, an increase of 25% in one year. Over a third of cases were in men who have sex with men, up from around a quarter in 2010.

Research suggests that up to a third of reported cases are repeat gonorrhoea infections.

Drug resistance

In England and Wales, the risk of gonorrhoea resistance developing in current first-line therapies, using the medications ceftriaxone and azithromycin fell slightly for the first time in five years in 2011. However, international concern has been focused on cases of treatment failure coupled with the fact that no new antimicrobial agents are in the pipeline for those diagnosed with gonorrhoea.

Professor Dame Sally Davies, the chief medical officer for England says in a statement: "We have seen a worrying rise in cases of drug resistant gonorrhoea over the last decade. Antimicrobial resistance to common drugs will increasingly threaten our ability to tackle infections and the Health Protection Agency's work is vital to addressing this threat."

The first case of antibiotic-resistant gonorrhoea was found in Japan in 2011. Similar cases have since been seen worldwide.

Reducing transmission

The Action Plan has been developed by the Gonococcal Resistance to Antimicrobials Surveillance Programme (GRASP) which was established by the HPA. It plans to reduce transmission rates and monitor for and detect resistance to medication.

Professor Cathy Ison, lead author of the GRASP Action Plan, says in a statement: "Ensuring treatment resistant gonorrhoea strains do not persist and spread remains a major public health concern. The GRASP Action Plan raises awareness of this important issue and sets out practical, measurable actions to extend the useful life of the current recommended therapies in England and Wales."

Safe sex

The HPA says that the risk of getting or transmitting gonorrhoea is reduced by:

  • Always using a condom correctly and consistently when having sex with new or casual partners until all partners have had a sexual health screen
  • Avoiding overlapping sexual relationships and reducing the number of sexual partners
  • Getting screened regularly if you are in one of the higher risk groups. Men who have sex with men should have an HIV and STI screen at least annually, and every three months if having unprotected sex with new or casual partners

Rebecca Findlay, spokesperson for sexual health charity the FPA, tells us by email: "We know that gonorrhoea is beginning to show some resistance to antibiotics, so it's essential that it's dealt with on a national rather than a regional level.

"The safer sex message also needs constant reinforcement if we’re going to avoid the ‘revolving door’ syndrome where people are contracting an STI, being treated and then being reinfected again."

Reviewed on February 27, 2013

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