E-DRUG: Growing antibiotic resistance forces updates on treatment for STIs
[Thanks to Lucas for spotting. WB]
News Release WHO/28
Growing antibiotic resistance forces updates to recommended treatment for
sexually transmitted infections
WHO releases new treatment guidelines for chlamydia, gonorrhoea and syphilis
30 AUGUST 2016 | GENEVA: New guidelines for the treatment of three common
sexually transmitted infections (STIs) have been issued by the World Health
Organization (WHO) in response to the growing threat of antibiotic resistance.
Chlamydia, gonorrhoea and syphilis are all caused by bacteria and they are
generally curable with antibiotics. However, these STIs often go undiagnosed
and they are becoming more difficult to treat, with some antibiotics now
failing as a result of misuse and overuse. It is estimated that, each year, 131
million people are infected with chlamydia, 78 million with gonorrhoea, and 5.6
million with syphilis.
Resistance of these STIs to the effect of antibiotics has increased rapidly in
recent years and has reduced treatment options. Of the three STIs, gonorrhoea
has developed the strongest resistance to antibiotics. Strains of
multidrug-resistent gonorrhoea that do not respond to any available antibiotics
have already been detected. Antibiotic resistance in chlamydia and syphilis,
though less common, also exists, making prevention and prompt treatment
When left undiagnosed and untreated, these STIs can result in serious
complications and long-term health problems for women, such as pelvic
inflammatory disease, ectopic pregnancy and miscarriage, and untreated
gonorrhoea and chlamydia can cause infertility in both men and women. Infection
with chlamydia, gonorrhoea and syphilis can also increase a person's risk of
being infected with HIV two to three fold. An untreated STI in a pregnant woman
increases the chances of stillbirth and newborn death.
“Chlamydia, gonorrhoea and syphilis are major public health problems worldwide,
affecting millions of peoples' quality of life, causing serious illness and
sometimes death. The new WHO guidelines reinforce the need to treat these STIs
with the right antibiotic, at the right dose, and the right time to reduce
their spread and improve sexual and reproductive health. To do that, national
health services need to monitor the patterns of antibiotic resistance in these
infections within their countries,” says Ian Askew, Director of Reproductive
Health and Research, WHO.
The new recommendations are based on the latest available evidence on the most
effective treatments for these three sexually transmitted infections.
Gonorrhoea is a common STI that can cause infection in the genitals, rectum,
and throat. Antimicrobial resistance has appeared and expanded with every
release of new classes of antibiotics for the treatment of gonorrhoea. Because
of widespread resistance, older and cheaper antibiotics have lost their
effectiveness in treatment of the infection.
WHO urges countries to update their national gonorrhoea treatment guidelines in
response to the growing threat of antibiotic resistance. National health
authorities should track the prevalence of resistance to different antibiotics
in the strains of gonorrhoea circulating among their population. The new
guideline calls on health authorities to advise doctors to prescribe whichever
antibiotic would be most effective, based on local resistance patterns. The new
WHO guidelines do not recommend quinolones (a class of antibiotic) for the
treatment of gonorrhoea due to widespread high levels of resistance.
Syphilis is spread by contact with a sore on the genitals, anus, rectum, lips
or mouth, or from mother to child during pregnancy. If a pregnant woman has
untreated syphilis and the infection is transmitted to the fetus, this often
causes it to die. In 2012, mother-to-child transmission of syphilis resulted in
an estimated 143 000 early fetal deaths/stillbirths, 62 000 neonatal deaths and
44 000 babies being born preterm/low-birth-weight.
To cure syphilis, the new WHO guideline strongly recommends a single dose of
benzathine penicillin - a form of the antibiotic that is injected by a doctor
or nurse into the infected patient's buttock or thigh muscle. This is the most
effective treatment for syphilis; more effective and cheaper than oral
Benzathine penicillin was recognized by the 69th World Health Assembly in May
2016 as an essential medicine which has been in short supply for several years.
Reports of stock outs have been received by WHO from antenatal care
representatives and providers in countries with high burdens of syphilis from
three WHO Regions. WHO is working with partners to identify countries with
shortages and help monitor global availability of benzathine penicillin to
close the gap between national needs and supply of the antibiotic.
Chlamydia is the most common bacterial STI and people with this infection are
frequently co-infected with gonorrhoea. Symptoms of chlamydia include discharge
and a burning feeling when urinating, but most people who are infected have no
symptoms. Even when chlamydia is asymptomatic, it can damage the reproductive
WHO is calling on countries to start using the updated guidelines immediately,
as recommended in the Global Health Sector Strategy for STIs (2016-2021)
endorsed by governments at the World Health Assembly in May 2016. The new
guidelines are also in line with the Global Action Plan on Antimicrobial
Resistance, adopted by governments at the World Health Assembly in May 2015.
When used correctly and consistently, condoms are one of the most effective
methods of protection against STIs.
For more information, please contact:
WHO Department of Communications,
Telephone: +41 22 791 44 58,
Mobile: +41 79 203 67 15,