New Antibiotic Shows Promise in Treating Drug-Resistant Gonorrhoea
Medics may soon have a solution to combat the rise of drug-resistant “super-gonorrhoea” with the development of a new antibiotic. In a large-scale clinical trial, the first new antibiotic in decades for treating gonorrhoea has shown positive results, according to the non-profit organization behind the drug’s development.
Gonorrhoea, caused by the bacterium Neisseria gonorrhoeae, affects nearly 100 million people worldwide each year. Over the past decade, there has been an alarming increase in cases of drug-resistant gonorrhoea. This disease is often symptomless, and if left untreated, it can lead to infertility, ectopic pregnancy, and increased transmission of HIV.
New antibiotics are rare in the pharmaceutical industry’s pipeline. The potential new treatment for gonorrhoea, called zoliflodacin, was initially developed by drug company AstraZeneca and later by its spin-off Entasis Therapeutics in Massachusetts. The drug targets an essential bacterial enzyme involved in cell replication.
The US National Institutes of Health funded a phase II clinical trial of zoliflodacin in 179 people with gonorrhoea in 2018, which reported positive results. However, the drug’s development was stalled until the Global Antibiotic Research and Development Partnership (GARDP), a non-profit organization based in Geneva, joined forces with Entasis to lead a large-scale trial.
The trial enrolled 930 people with gonorrhoea across South Africa, Thailand, the United States, Belgium, and the Netherlands. Participants received either zoliflodacin or the standard treatment for the disease, which consisted of an injection of an antibiotic called ceftriaxone and an oral dose of azithromycin. The trial found that zoliflodacin was equally effective in curing infections compared to these standard drugs, with no resistant strains detected in patient samples.
The results of the trial are considered groundbreaking, given the urgency to find a solution to drug-resistant gonorrhoea. Ceftriaxone-resistant strains of N. gonorrhoeae have emerged worldwide and are spreading in some countries, with some strains also becoming resistant to azithromycin. This situation raises concerns about the disease becoming untreatable.
To prevent resistance to zoliflodacin, the drug is being developed solely for the treatment of gonorrhoea and other sexually transmitted infections (STIs). However, regulatory and public-health agencies will need to determine when and how the drug can be used. New diagnostics that can quickly distinguish gonorrhoea from other STIs are expected to be available in the near future, while tests to identify drug resistance are still in development. National surveillance programs for antibiotic-resistant gonorrhoea can guide the responsible use of zoliflodacin.
The Global Antibiotic Research and Development Partnership has a license to sell the drug in most parts of the world, while Entasis has marketing rights for the remaining territories. The cost of zoliflodacin has not been disclosed but hopes are to make it affordable, similar to existing treatments, which generally cost a few dollars per course.
The fight against drug-resistant gonorrhoea may have found a ray of hope with this groundbreaking new antibiotic.