New gonorrhoea treatment hailed as breakthrough in fight against drug resistance
The sexually transmitted infection can result in serious complications if it is not treated promptly, especially for women, for whom it can lead to increased risks of ectopic pregnancy and infertility.
Cases of drug-resistant gonorrhoea have increased rapidly in recent years, reducing the options for treatment. There is an urgent need for new treatments for gonorrhoea, with no new antibiotics found since the 1990s.
Now a study has suggested that gepotidacin, an antibiotic used to treat urinary tract infections, could be used to fight the infection, ward off drug-resistant cases and improve patient experiences.
The phase-three results of the randomised control trial were published in the Lancet journal and presented at the annual European Society of Clinical Microbiology and Infectious Diseases (ESCMID) conference in Vienna, Austria, on Monday. The trial was led by UK and US researchers and involved patients from the UK, US, Australia, Germany, Mexico and Spain
In the study of 622 patients, researchers compared gepotidacin, taken as a pill, with the standard treatment of ceftriaxone, an injection, and azithromycin, a pill.
They found the new pill to be as effective as the standard treatment at tackling the infection.
Crucially, gepotidacin was effective against strains of the gonorrhoea bacteria that are resistant to existing antibiotics. There were no treatment-related severe or serious side-effects for those treated with either medication, the Lancet reported.
The investigators said the new treatment could be an important tool in combatting the rise of gonorrhoea strains that are becoming resistant to the standard treatment. Additionally, treatment as a pill alone without the need for an injection would probably improve patient experiences and reduce the required healthcare resources.
The authors said gepotidacin 'demonstrated non-inferiority to ceftriaxone plus azithromycin' and offered a 'novel oral treatment option for uncomplicated urogenital gonorrhoea'.
They added: 'Gepotidacin is a novel oral antibacterial treatment with the potential to become an alternative option for the treatment of gonococcal infections.'
The authors also cautioned that the study looked primarily at urogenital gonorrhoea and that most of the patients were white men. Therefore more research was needed to see the impact of the treatment on gonorrhoea of the rectum and throat, and in women, children, and patients of other ethnicities.
Gonorrhoea is becoming increasingly resistant to antibiotics, with health officials previously warning it could be untreatable in the future.
Last year officials in England issued a warning about a rise in super-strength cases.
There were 85,000 cases of gonorrhoea diagnosed in England in 2023, the highest level since records began in 1918.
The vast majority of cases can be treated. But there has been an increase in people diagnosed with strands that are resistant to ceftriaxone, the 'first line' antibiotic typically used to treat the infection.
Most of those affected in England were in their 20s, heterosexual, and acquired the infection abroad, though some had no travel history, the UK Health Security Agency (UKHSA) said.
Global health leaders have previously warned that antimicrobial resistance poses a significant threat to humanity, with data showing it has become a leading cause of death worldwide and is killing about 3,500 people every day.
More than 1.2 million – and potentially millions more – died in 2019 as a direct result of antibiotic-resistant bacterial infections, according to a comprehensive 2022 estimate of the global impact of antimicrobial resistance.
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