Future Prospects for Neisseria gonorrhoeae Treatment

Abstract

Gonorrhea is a sexually transmitted disease with a high morbidity burden. Incidence of this disease is rising due to the increasing number of antibiotic-resistant strains. Neisseria gonorrhoeae has shown an extraordinary ability to develop resistance to all antimicrobials introduced for its treatment. In fact, it was recently classified as a “Priority 2” microorganism in the World Health Organization (WHO) Global Priority List of Antibiotic-Resistant Bacteria to Guide Research, Discovery and Development of New Antibiotics. Seeing as there is no gonococcal vaccine, control of the disease relies entirely on prevention, diagnosis, and, especially, antibiotic treatment. Different health organizations worldwide have established treatment guidelines against gonorrhea, mostly consisting of dual therapy with a single oral or intramuscular dose. However, gonococci continue to develop resistances to all antibiotics introduced for treatment. In fact, the first strain of super-resistant N. gonorrhoeae was recently detected in the United Kingdom, which was resistant to ceftriaxone and azithromycin. The increase in the detection of resistant gonococci may lead to a situation where gonorrhea becomes untreatable. Seeing as drug resistance appears to be unstoppable, new treatment options are necessary in order to control the disease. Three approaches are currently being followed for the development of new therapies against drug-resistant gonococci: (1) novel combinations of already existing antibiotics; (2) development of new antibiotics; and (3) development of alternative therapies which might slow down the appearance of resistances. N. gonorrhoeae is a public health threat due to the increasing number of antibiotic-resistant strains. Current treatment guidelines are already being challenged by this superbug. This has led the scientific community to develop new antibiotics and alternative therapies in order to control this disease.

Multiresistant Neisseria gonorrhoeae: a new threat in second decade of the XXI century

“…The emerging resistance mechanisms force the introduction of new drugs and change of treatment regimens. The timetable of appearance of the resistance in N. gonorrhoeae to particular drugs is shown in the Table 1 [7,15,[26][27][28][29][30]. The arising, presently still rare in this species, resistance to third-generation cephalosporins is of particular importance for N. gonorrhoeae.…”

“…zoliflodacin and gepotidacin. Examples of protein synthesis inhibitors are new drugs that entered clinical trials: lefamulin and solithromycin and drugs only in preclinical tests: apramycin (aminoglycoside) and aminomethyl spectinomycins [11][12][13][14][15][16][17][18]. Another candidate for gonorrhoea treatment with a new mechanism of action, a small antimicrobial molecule SMT-571, demonstrated in vitro high activity against all investigated strains of N. gonorrhoeae [19].…”

Efficacy and Safety of Injectable and Oral Antibiotics in Treating Gonorrhea: A Systematic Review and Network Meta-Analysis

“…Neisseria gonorrhoeae is a Gram-negative diplococcus and the etiological agent of gonorrhea, a sexually transmitted infection (STI). There are 78-106 million new cases of gonorrhea worldwide each year, with a global incidence rate of 19 per 1000 females and 24 per 1000 males [1], and the rate of transmission has doubled in the last five years in several countries, including Australia [2].…”

Desigualdades sociales relacionadas con la resistencia a antimicrobianos de N. gonorrhoeae en Colombia

“…resistentes a los antibióticos (6). Cada año, 106 millones de personas contraen esta enfermedad (7) por tener relaciones sexuales anales, vaginales u orales con una persona infectada; mujeres embarazadas con gonorrea pueden transmitirla a su bebé durante el parto (6). El aislamiento de N. gonorrhoeae mediante cultivo es el método estándar para el diagnóstico (8,9).…”