Spread of Super-Gonorrhoea across the UK

Posted 18 April 2016

Gonorrhoea is the second-most common bacterial Sexually Transmitted Infection, STI, in the UK after chlamydia - and overall, there were almost 35,000 cases of gonorrhoea reported in England alone last year.[1]New Doctors scribble

In 2011 the British Association for Sexual Health and HIV, BASHH, gonorrhoea treatment guidelines were changed to an intra-muscular injection of 500mg of ceftriaxone in combination with a 1g oral dose of azithromycin as first-line therapy.[2] For those who find it difficult to access a sexual health clinic, choose not to visit their GP or do not want an injection we supply the alternative dual treatment of an oral dose of 400g cefixime and 1g of azithromycin taken together as a single dose. We also supply a free test of cure to make sure that the treatment has been effective.

An outbreak of a resistant strain of gonorrhoea began in Leeds six months ago and then spread to Scunthorpe, Macclesfield and Oldham and has now more recently been found in the West Midlands and the South-East of England.

Public Health England, PHE, said on Sunday there had been 34 confirmed cases since November 2014.[3] Since September 2015, 11 cases have been confirmed in the West Midlands and in the South East of England, five of which were in London.

This particular strain of gonorrhoea, known as HO41, is highly resistant to azithromycin, the drug most commonly used in dual therapy to treat the infection.[4] HO41 has so far proved resistant to current antibiotic treatment and so it has been placed in the superbug category. Instances of this particular strain were previously rare, according to the BASHH guidelines and they added: "PHE is concerned that the effectiveness of current frontline dual therapy for gonorrhoea will be threatened if this resistant strain continues to spread unchecked."

There are no other effective drugs to tackle the resistant strain, raising the prospect of it becoming untreatable if it builds further resistance.

About 50% of women and 10% of men are unaware that they’re infected as they don’t experience any obvious symptoms and this means that the infection can go untreated until the disease has progressed. This can lead to serious long term health problems and infertility.

PHE have urged people to use condoms with new or casual partners to cut the risk of catching the disease and anyone beginning a new relationship should get tested along with their partner.

There is more information on our website about the symptoms in both men and women and on testing and treatment.

Medically reviewed by: Super intendent pharmacist Margaret Hudson BSc(Hons)MRPharmS 18/04/16

References

[1] Public Health England. Sexual and Reproductive Health Profiles [cited 2016 Apr 17]. Available from: http://fingertips.phe.org.uk/profile/sexualhealth/data#page/0

[2] BASHH. UK national guideline for the management of gonorrhoea in adults [cited 2016 Apr 17]. Available from: http://www.bashh.org/documents/3920.pdf

[3] Public Health England. GOV.UK. Safe sex reminder as antibiotic resistant gonorrhoea investigations continue; 2016 Apr 17 [cited 2016 Apr 17]. Available from: https://www.gov.uk/government/news/safe-sex-reminder-as-antibiotic-resistant-gonorrhoea-investigations-continue

[4] Science World Report. Science World Report. Gonorrhea HO41 Superbug may be ‘worse than AIDS’; 2013 May 6 [cited 2016 Apr 17]. Available from: http://www.scienceworldreport.com/articles/6672/20130506/gonorrhea-ho41-superbug-worse-aids.htm

Medically reviewed by: Superintendent pharmacist Margaret Hudson BSc(Hons)MRPharmS 18/04/16

Posted in Sexual Health