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Gonorrhea: The New AIDS

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A few weeks ago, the news wires picked up a story concerning the discovery of a gonorrhea super-bug that is resistant to most forms of antibiotics. The headlines screamed: “Worse Than AIDS.” Almost immediately, the CDC was quick to respond: stating that the deadly strain had not been detected in the US. Yet! Right way, I am reminded of the early reports, when I was a kid, on the emergence of a new “gay cancer.” It hadn’t been designated AIDS yet. The news reporters said that the disease was localized in gay male populations and among Haitians. Everyone breathed a sigh of relief. Now, 30 years later, and after the death of millions, we know the truth.

Since 1986, the United States Gonococcal Isolate Surveillance Project (GISP) has been monitoring antibiotic resistance to gonorrhea. According to GISP, by 2010, 27% of all of the gonorrhea samples were resistant to penicillin, tetracycline, and ciprofloxacin, or some combination of these drugs. By 2010, 27% of all gonorrhea tested was resistant to three major antibiotics or some combination of these drugs. Cefixime, an oral cephalosporin antibiotic (cephalosporins are a sub-group of beta-lactam antibiotics, like carbapenems) was the recommended antibiotic for gonorrhea treatment, until gonorrhea began to develop resistance that drug too. In 2012, the CDC updated its treatment guidelines and now recommends an injectable cephalosporin, called ceftriaxone, along with azithromycin or doxycycline, instead of oral cephalosporins. Combination therapies (meaning more than one antibiotic) provide almost a one-two punch against these bacteria—so the hope is that this remains effective. But cephalosporins are our last line of antibiotic defense against gonorrhea. As authors wrote in 2012 in a piece in the New England Journal of Medicine, it is now “time to sound the alarm.” Simply put, the outlook is not good. In 2011, doctors from Japan published a case study revealing that gonorrhea was acquiring even more resistance—this time, to injectable ceftriaxone. Since then, samples of ceftriaxone-resistant gonorrhea have been detected in France and Spain, too, reports the CDC.

*Authors Note: About 20 years ago, I caught this disease. It was pure agony. At the time, I was mentally deranged; therefore I didn’t take very good care of myself. When I finally visited a physician, I had been sick for at least a few months. It took several courses of different antibiotics to eventually rid my body of the infection. While on the medication, I was constantly in pain, couldn’t stop having diarrhea, and lost a lot of weight. Now, it all reminds me of what a dear friend said to me, while he was dying with AIDS: “It wasn’t worth it.”

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