A new treatment for gonorrhea shows promise, which is welcome news with global rates of the sexually transmitted infection on the rise and antibiotic resistance becoming more prevalent.
The oral antibiotic gepotidacin, used to treat urinary tract infections, was as effective as current treatments for uncomplicated gonorrhea and powerful against strains of the bacteria that are resistant to other antibiotics, a study published Monday in the Lancet showed.
A novel treatment for the sexually transmitted disease is significant, because only one reliable treatment still exists, and President Donald Trump's administration has shut down the federal lab that monitors STI rates.
Gonorrhea is a sexually transmitted bacterial infection that spreads through semen and vaginal fluid. People also can become infected with gonorrhea through oral and anal sex and can pass it to infants during childbirth. It is the second most common STI caused by a bacteria in the United States, behind chlamydia, according to the Cleveland Clinic. It causes about 1 million new infections a year, primarily in young men.
Gonorrhea rates reached a historic low in the United States in 2009 and then steadily increased through 2021. Reported cases have dipped in recent years, with a 9.2% decrease from 2021 to 2022 and a 7.7% decrease between 2022 and 2023, according to the most recent statistics available from the Centers for Disease Control and Prevention.
But the STI has been increasing among young men, with 550.5 cases per 100,000 men ages 15 to 24 in 2022 compared to 523.5 cases per 100,000 men in that age group in 2017, according to the Department of Health and Human Services.
Additionally, a 2024 report from the World Health Organization found that cases of antibiotic-resistant gonorrhea are rising. Nine countries reported elevated levels of gonorrhea strains that were resistant to ceftriaxone, the last line treatment for gonorrhea.
"Widespread resistance" of gonorrhea means that "there is the risk that soon gonorrhea will be impossible to treat in the absence of new drugs or strategies to curb the burden of disease," according to an editorial published in the Lancet alongside the new research.
The study involved 622 people, comparing the effectiveness of the new antibiotic to the standard treatment — an injection of the antibiotic ceftriaxone. New antibiotic treatment with gepotidacin may be more effective against resistant gonorrhea and may also improve compliance among people wary of injections, the researchers said.
But the study had limitations because it involved mostly white men and primarily looked at urogenital gonorrhea, a type of the infection that infects the genital tract. People also can get gonorrhea in the throat through oral sex and in the rectum through anal sex.
Gonorrhea can lead to serious health issues, including infertility in men and women, pelvic inflammatory disease in women and, more rarely, septic arthritis, characterized by warm, red, swollen and painful joints. But often people who have gonorrhea have no symptoms.
Signs of gonorrhea in men include painful urination, pain or swelling in one testicle and a pus-like discharge from the penis. Women may experience increased vaginal discharge, painful urination, vaginal bleeding in between periods and abdominal or pelvic pain, according to the Mayo Clinic.
Gonorrhea also can cause anal itching, discharge and some bleeding from the rectum, as well as straining during bowel movements. Gonorrhea sometimes affects the eyes, causing pain, sensitivity to light and discharge. Swollen lymph nodes and a sore throat may accompany gonorrhea that affects the throat.