There’s only one effective oral antibiotic treatment currently used to treat gonorrhea in North America — but that number might soon drop to zero, since researchers have identified the first cases of gonorrhea immune to the antibiotic.
A study released in the Journal of the American Medical Association on Tuesday found that nearly seven percent of the patients at a Toronto clinic remained infected with the disease even after a round of oral cephalosporins, the lone remaining oral antibiotic that can effectively treat the resistant strains of gonorrhea. This presents a potential long-term public health crisis for the United States, where gonorrhea is the second most common sexually transmitted disease with 321,849 cases reported in 2011. The Center for Disease Control (CDC) already issued guidance to physicians in August steering them away from oral cephalosporins as a first line treatment for gonorrhea, citing resistance risks.
According to the Australian School of Business, pharmaceutical companies’ greed presents one of the major roadblocks to developing better antibiotics:
Part of the problem is that the business case for developing an antibiotic — especially one for the percentage of people currently resistant to them — is extremely poor, according to Taylor, who tests patient samples and reports on antibiotic resistance. One of the first cases of a patient infected with an organism carrying New Delhi metallo-beta-lactamase (a superbug) was reported from a Sydney hospital in collaboration with a French laboratory, Taylor notes.
Antibiotic resistance is becoming more common, but for pharmaceutical companies the “superbug” bacteria requiring treatment are less appealing targets for drug development than conditions that require long-term medication, such as statins (cholesterol-lowering drugs), anti-depressants, beta-blockers or anti-rheumatics, Taylor says.
That’s why gonorrhea is just one of the many diseases developing resistance to commonly used antibiotics as a result of misuse, including over-prescription by physicians and patients not taking their complete courses. For instance, the estimated number of hospital stays involving methicillin-resistant Staphylococcus aureus (MRSA) infections in the U.S. rose from 1,900 in 1993 to a staggering 368,000 in 2005 — yet, despite calls to action for the development of new antibiotics, only 83 of the more than 2,950 medicines under development in 2010 were antibiotics.
Pharmaceutical companies may have some more time before resistant strains of gonorrhea spread. But with a public health problem of this magnitude on the horizon, they may need to re-evaluate their position on antibiotic development soon.