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Journalism of Courage
Ramesh (name changed), 46, was on a work trip to New Delhi when he experienced a burning sensation during urination along with a yellowish discharge. He decided to consult his doctor, Dr I.S. Gilada, consultant at Unison Medicare and Research Centre, who advised him to send a urine sample back to Mumbai by flight. A test confirmed gonorrhoea, a common sexually transmitted infection (STI). Dr Gilada recommended an intramuscular injection of ceftriaxone. Ramesh experienced significant relief the very next day.
But he could have even taken an oral antibiotic as well. A new study in The Lancet has sparked interest by suggesting that gepotidacin, an oral antibiotic commonly used for urinary tract infections, could serve as an effective new treatment for this STI. Experts have welcomed this potential alternative, especially for patients wary of injections and drug-resistant variants of the disease.
With no new antibiotic being developed, Dr Gilada (not attached with the study) says cases of gonorrhoea, which had gone down from 2000 to 2015 following HIV awareness and condom promotion, are rising. “The current trend shows increasing cases of gonorrhoea among men who have sex with men or transsexuals. I see at least two cases per week,” he says.
What the study says
A phase 3 multi-centre trial, conducted between October 21, 2019, and October 10, 2023 among 622 patients, found the oral pill gepotidacin to be as effective with the current standard treatment (ceftriaxone – an injection, and azithromycin – a pill) in treating gonorrhoea. “The new pill was effective against strains of the gonorrhoea bacteria that are resistant to existing antibiotics. There were no treatment-related severe side effects for those treated with either medication,” said Jonathan D C Ross from the Department of Sexual Health and HIV, Birmingham University Hospitals NHS Foundation Trust, Birmingham, UK.
What was the need for a new treatment for gonorrhoea?
As per the Lancet study, there is an urgent need for new treatments for gonorrhoea because no new antibiotics have been developed since the 1990s. “Gonorrhoea is a common sexually transmitted infection which, if not treated promptly, can result in serious complications, especially for women where 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,” wrote authors. They said the new treatment protocol could be an important tool in combating the rise of gonorrhoea strains that are becoming resistant to the standard treatment.
According to Dr Abdul Ghafur, senior consultant in infectious diseases, Apollo Hospital, Chennai, azithromycin resistance in gonorrhoea is very high with ceftriaxone resistance being reported increasingly. He’s looking forward to another drug, zoliflodacin, which has already completed Phase 3 trials. “It has shown good activity against azithromycin- and ceftriaxone-resistant gonococcus. These two oral agents — zoliflodacin and gepotidacin — are very welcome additions in the battle against drug-resistant gonorrhoea,” he adds.
