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New Gonorrhea Treatments Show Promise in CDC/NIH Study

Additional options urgently needed (July 16)

Two new antibiotic regimens using existing drugs — injectable gentamicin in combination with oral azithromycin, and oral gemifloxacin in combination with oral azithromycin — have successfully treated gonorrhea infections in a clinical trial conducted by the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH). The study’s objective was to identify new treatment options in the face of growing antibiotic resistance.

The new findings were presented July 16 at the 20th Meeting of the International Society for Sexually Transmitted Diseases Research (ISSTDR) in Vienna, Austria.

All of the drugs studied in the trial were FDA-approved and are available in the U.S. This is the first clinical trial to evaluate them as combination therapy for gonorrhea.

The researchers found 100% effectiveness of the injectable gentamicin/oral azithromycin combination in curing genital gonorrhea infections, and 99.5% effectiveness of the oral gemifloxacin/oral azithromycin combination. Both combinations cured 100% of infections of the throat and rectum. However, many trial participants reported adverse effects from the drugs, mostly gastrointestinal issues.

The new findings do not change current gonorrhea treatment guidelines. The CDC still recommends only one first-line treatment regimen: injectable ceftriaxone in combination with one of two other oral antibiotics, either azithromycin or doxycycline. This regimen remains highly effective in treating gonorrhea and causes limited side effects. However, providers may consider using the regimens studied in the new trial as alternative options when ceftriaxone cannot be used, such as in the case of a severe allergy.

The CDC is taking the findings of the new study into consideration for inclusion in future treatment guidelines.

Source: NIH; July 15, 2013.

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