Gonorrhea Treatments

Gonorrhea Treatments 2024

Gonorrhea can be treated with antibiotics; however, the bacteria have developed resistance to some treatments, and treatment will not repair any permanent damage done by the disease, says the U.S. Centers for Disease Control and Prevention (CDC). The WHO announced on July 24, 2023, that the spread of a Neisseria gonorrhea clone highly resistant to ceftriaxone is increasingly being reported in various countries. 

Gonorrhea Treatment Candidates

GSK plc announced on April 17, 2024, positive headline results from the pivotal EAGLE-1 phase III trial for gepotidacin (GSK2140944). Gepotidacin achieved a 92.6% microbiological success rate and was non-inferior to the leading combination treatment. Gepotidacin is an investigational bactericidal, first-in-class triazaacenaphthylene antibiotic that inhibits bacterial DNA replication by a novel mechanism of action and binding site and, for most pathogens, provides well-balanced inhibition of two different Type II topoisomerase enzymes. This provides activity against most strains of target uropathogens (such as E. coli and S. saprophyticus) and N. gonorrhoeae, including isolates resistant to several antibiotics. Due to the well-balanced inhibition of two enzymes, gepotidacin target-specific mutations are needed to affect gepotidacin susceptibility significantly. EAGLE-2 and EAGLE-3 were phase 3 studies that found that Gepotidacin is an efficacious oral antibiotic with acceptable safety and tolerability profiles.

On November 1, 2023, the journal Nature published an article: The potential new super gonorrhea treatment, called zoliflodacin, developed initially by drug firm AstraZeneca and later by its spin-off Entasis Therapeutics, targets an essential bacterial enzyme that untangles DNA during cell replication. Zoliflodacin has a unique mechanism of action that inhibits a crucial bacterial enzyme called type II topoisomerase, which is essential for bacterial function and reproduction.

The NEJM journal published Original Research on April 6, 2023, which found that gonorrhea incidence was low with doxycycline postexposure prophylaxis. The Lancet Infectious Disease wrote on June 12, 2023, that there is increasing evidence that doxycycline post-exposure prophylaxis (doxy-PEP) effectively prevents sexually transmitted infections among high-risk patients, particularly in patients using HIV preexposure prophylaxis. Overall, the risk of selecting dual-resistant strains and increasing N gonorrhea ceftriaxone resistance must be carefully balanced against the benefits of using doxy-PEP to prevent and treat sexually transmitted infections. The randomized phase of the DOXYVAC clinical study was stopped in August 2022 when DoxyPEP, a U.S. study presented at the International AIDS Conference, found that doxycycline PEP cut the risk of gonorrhea by 55%. In California, doxy-PEP is recommended for certain people.

Gonorrhea Tests

CARB-X announced on April 18, 2024, that it will award up to $1 million to diagnostics and health tech company Scout to demonstrate proof-of-concept and feasibility ahead of developing a new point-of-care test, STI Scout. The test will detect and differentiate between Neisseria gonorrhoeae and Chlamydia trachomatis.