Global rates of gonorrhoea are soaring, driven by increasingly antibiotic-resistant strains of the bacteria. Two new treatments, approved in December 2023, represent a significant step forward in combating this growing public health crisis. These approvals mark the first new options in decades and come at a critical time, as existing antibiotics become less effective.
The Growing Threat of Superbug Gonorrhoea
Gonorrhoea affects over 82 million people worldwide annually, with particularly high infection rates in Africa and the Western Pacific region. Cases in England and across Europe have surged in recent years, with resistance to first-line antibiotics like ceftriaxone and cefixime rising sharply. The World Health Organization (WHO) now lists gonorrhoea as a “priority pathogen” due to this escalating resistance.
This matters because untreated gonorrhoea can lead to serious complications, including infertility, and fuels further spread of drug-resistant strains. The current standard treatment – a combination of ceftriaxone and azithromycin – is losing its effectiveness, meaning infections become harder, and sometimes impossible, to treat.
Two New Treatments Approved
The two newly approved drugs are zoliflodacin (Nuzolvence) and gepotidacin. Zoliflodacin, developed through a non-profit collaboration between GARDP and Innoviva, has shown over 90% effectiveness in clinical trials. It offers a single-dose, oral treatment option, which could simplify administration and improve patient compliance. Gepotidacin, from GSK, also demonstrated efficacy against drug-resistant strains in trials.
These drugs represent a new class of antibiotics that may slow the development of resistance. However, targeted use will be essential to prevent further mutations. The approval of these treatments is particularly significant for low- and middle-income countries, where access to effective care is often limited.
A Turning Point in Antibiotic Development
The development of zoliflodacin exemplifies a new model for antibiotic research: non-profit partnerships working with pharmaceutical companies. This approach may be vital in addressing the broader crisis of antibiotic resistance, where drug development has lagged behind the spread of superbugs.
As Dr. Tereza Kasaeva of the WHO stated, these approvals are “an important and timely development.” For clinicians like Dr. Rossaphorn Kittiyaowamarn in Thailand, where drug-resistant gonorrhoea is rampant, these new treatments will be a “game-changer” for controlling the disease and protecting public health.
The fight against antibiotic resistance is far from over, but these new treatments provide critical tools in a growing battle. Strategic implementation and ongoing surveillance will be essential to ensure their long-term effectiveness.
