The organism that causes gonorrhoea, Neisseria gonorrhoeae, can adapt and build up resistance to treatment. The first antibiotic it managed to beat was penicillin, which had been curing gonorrhoea infections for the first 70 years from when the medicine was first introduced.
Cases of gonorrhoea resistant to the antibiotic azithromycin have occurred in England, with Public Health England (PHE) reporting 34 cases between November 2014 and April 2016. The cases have been confirmed in both heterosexual men and women, as well as in men who have sex with men. Although the strain of gonorrhoea in that outbreak was treatable by a second antibiotic, ceftriaxone, resistance could build up to that drug, too.
The World Health Organisation (WHO) currently recommends a combination of both ceftriaxone, which is given by injection, and azithromycin, which is taken by mouth.
Antimicrobial resistance occurs when a strain of bacteria evolves to resist each consecutive treatment until no treatments are left, leaving these so-called 'superbugs' incurable. Some strains of N. gonorrhoeae are now currently untreatable due to the lack of alternative treatments. The first case of antibiotic-resistant gonorrhoea was reported in Japan in 2011, and similar cases have since been found worldwide.
Closthioamide, a new class of natural antibiotics discovered in 2010, might eventually offer an alternative for current drugs that are becoming less effective against gonorrhoea. For the first time, researchers from Imperial College London and the London School of Hygiene and Tropical Medicine have tested closthioamide on gonorrhoea samples in the laboratory.
The researchers used 149 samples of N. gonorrhoeae taken from hospital patients with infections in the throat, urethra, cervix and rectum. They found that very low amounts (equal to or less than 0.125mg/L) of closthioamide was effective against 146 of the 149 samples – and against all of the samples provided to them by WHO that were known to be resistant to other antibiotics. The results of the study are published in the journal Antimicrobial Agents and Chemotherapy.
This laboratory-based study is in an early stage of research. The drug has not yet been tested on animals and humans, but the researchers say the antibiotic shows tremendous promise and could be an exciting new step in the fight against gonorrhoea. However, further research is necessary to assess the drug's safety and effectiveness, and it will be a number of years before closthioamide can be used in real-life human cases.
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