In the battle against drug-resistant infections, a potential breakthrough has emerged.
The Global Antibiotic Research and Development Partnership (GARDP), a non-profit organisation, has successfully conducted a phase-three trial for a new antibiotic, “zoliflodacin“, which is aimed at treating gonorrhoea.
This sexually transmitted infection (STI) affects millions of people worldwide and has become increasingly resistant to existing treatments.
Gonorrhoea is one of the most common STIs, infecting an alarming number of people each year. Africa, in particular, bears the brunt of these infections, with 11.4 million new cases reported annually.
In South Africa alone, two million new cases are detected every year. The symptoms of gonorrhoea usually appear within two weeks of infection, but it often goes undetected as it can be asymptomatic.
If left untreated, it can lead to severe complications such as pelvic inflammation, infertility, and an increased risk of HIV transmission.
The urgency for new treatments has been heightened by the rise of drug-resistant gonorrhoea infections. A 2017 survey conducted by the World Health Organization (WHO) revealed that 97% of the 77 countries surveyed reported cases of drug resistance to common gonorrhoea antibiotics.
In addition, two-thirds of the countries reported resistance or decreased susceptibility to the last available treatment option using a single drug. The need for new antibiotics to combat this growing problem is more pressing than ever.
“Zoliflodacin” is an oral antibiotic that has shown promising results in the global clinical trial.
The trial, which took place in South Africa, the United States, the Netherlands, and Thailand, involved 930 participants with uncomplicated gonorrhoea.
These participants included women, individuals living with HIV, and adolescents. This trial is the largest ever conducted for a new gonorrhoea treatment. The findings are expected to be published in a peer-reviewed journal next year.
Professor Sinead Delany-Moretlwe, the director of research at the Reproductive Health and HIV Institute at Wits University, led the South African arm of the trial.
She expressed her excitement about the results, highlighting the urgent need for new diagnostics, therapies, and preventive interventions to reduce the burden of STIs in our communities.
“This is an exciting result. It certainly places the spotlight on the much-needed field of STIs; and the need for new diagnostics, therapies and preventive interventions to reduce the burden of STIs in our community,” Professor Sinead Delany-Moretlwe the director of research at the Reproductive Health and HIV Institute at Wits (Wits RHI) told Health Watch.
The WHO has designated gonorrhoea as a “priority pathogen,” yet no new treatments have been trialled in the past four decades.
But Delany-Moretlwe explained that the oral pill has the potential to simplify gonorrhoea treatment as it only requires a single oral dose.
“Zoliflodacin is simpler to administer than the current therapy,” she explained.
“From a treatment perspective, this is helpful as it ensures same day directly observed therapy ensuring treatment completion.”
The “zoliflodacin” breakthrough brings hope for a new weapon in the fight against drug-resistant gonorrhoea.
If approved, this oral pill could provide a much-needed solution to combat this widespread and stubborn infection, read the GARDP statement.
Currently, gonorrhoea treatment in South Africa follows a syndromic approach, where patients with STIs receive a combination of drugs that can treat multiple pathogens causing similar symptoms.
This means that the same treatment is given for a set of symptoms, regardless of the specific pathogen causing the infection.
The difficulties in treating gonorrhoea, particularly in women, are highlighted due to the challenge of diagnosing asymptomatic infections.
As a result, women who do not have noticeable symptoms or fail to recognise them may not seek treatment, leading to untreated infections.
The consequences of leaving gonorrhoea untreated can pose serious risks to one's health, according to studies.
Here's what recent research has uncovered:
A study published in the “Sexually Transmitted Diseases” journal discovered that individuals with untreated gonorrhoea are at a higher risk of acquiring and transmitting HIV. This highlights the critical need for prompt and effective treatment to reduce the risk of HIV transmission.
Research published in the “Journal of Infectious Diseases” revealed that untreated gonorrhoea in women can lead to pelvic inflammatory disease (PID), causing chronic pelvic pain, infertility, and an increased risk of ectopic pregnancy. This speaks to the importance of early detection and treatment to safeguard women's reproductive health.
Another study, published in “The New England Journal of Medicine,” highlighted the potential long-term risks for men with untreated gonorrhoea, including a condition called epididymitis.
This inflammation of the epididymis can cause chronic testicular pain and potential fertility issues, underscoring the significance of timely diagnosis and treatment.
Delany-Moretlwe is hopeful that the participation of South Africans in the zoliflodacin trial will help to speed up the registration of oral gonorrhoea treatment in the country.