A study suggests that a recently approved antibiotic in the US for treating urinary tract infections could also be useful against sexually transmitted infections, one of the fastest-growing infections in recent years that is developing resistance to available therapies.
Neutrophils attacking bacteria of the genus 'Neisseria gonorrhoeae'.James VolkCDC
Just over two weeks ago, the US Food and Drug Administration (FDA) approved a new antibiotic indicated for treating urinary tract infections in women.
The active ingredient, called gepotidacin and developed by GSK, is the first drug of a new class of antibiotics to reach the clinic after decades without therapeutic innovations for uncomplicated urinary tract infections.
In addition to this indication, the treatment could also be useful against gonorrhea, as shown in a new study published in The Lancet and presented at the Congress of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID), being held between April 11 and 15 in Vienna, Austria.
According to the data from the Phase III trial, the treatment is as effective against the sexually transmitted infection as conventional therapy, providing new weapons against the disease and reducing the risk of resistance. The treatment works by inhibiting the replication of the DNA of the bacteria responsible for the infection.
Gonococcal infection, also known as gonorrhea, is a rising STI that has continued to grow in recent years. The latest epidemiological surveillance report on STIs in Spain, prepared by the Carlos III Health Institute and published last October, showed that between 2021 and 2023, the cases of this condition nearly doubled in Spain, with an average annual increase of 42.6% and a total of 34,401 infections recorded in 2023.
This infection is caused by the bacterium Neisseria gonorrhoeae and can be acquired through unprotected sexual intercourse. Although in many cases it can remain asymptomatic, some signs of infection may include a burning sensation when urinating, increased urinary frequency, abdominal pain, fever, pain during sexual intercourse, throat irritation, or sensitive or swollen testicles. If left untreated, the problem can lead to serious complications such as pelvic inflammatory disease or infertility.
In addition to its expansion, specialists are concerned about the emergence of strains resistant to treatments, especially considering that the arsenal of antibiotics for this issue has not increased since the introduction of cephalosporins in the 1990s.
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This new trial, whose results were presented at the annual meeting of European microbiologists, followed 622 patients with urogenital gonorrhea (some recruited in Spain), comparing the effects of gepotidacin, an oral treatment (two doses of 3 g), against those of standard therapy, an injection of ceftriaxone along with an oral dose of azithromycin.
The analysis showed that the treatment was as effective as the usual therapy for treating the infection and also helped combat antibiotic-resistant strains. The researchers highlighted in the scientific journal that no serious side effects were reported in any of the study groups. Although they caution that the study was mainly conducted in white adult men with urogenital infections, and therefore, further studies are needed to confirm if the treatment is also effective in cases of infection in women, adolescents, individuals of different ethnic backgrounds, as well as in infections occurring in other mucous membranes such as the throat or rectum, the authors of the study believe that the new treatment could be an important weapon against this rising infection.
In a commentary accompanying the research in the scientific journal, Magnus Unemo and Teodora Wi, STI specialists from Örebro University in Sweden, point out that gonorrhea "remains a significant threat to global public health."
The new treatment is "promising", but on its own, it will not solve the challenges posed by STIs, they indicate.
Therefore, the control of gonorrhea should include improvements in prevention, early diagnosis, patient and contact treatment, enhanced surveillance, and antimicrobial administration. "It remains imperative to have rapid, effective, and affordable diagnostic tests for N. gonorrhoeae and resistance determinants, as well as new antimicrobials and ideally vaccines," they conclude.
According to the World Health Organization (WHO), around 82.4 million cases of gonorrhea occurred worldwide in 2020, in individuals aged 15 to 49 years.