No Applause For Britain's Treatment Of The Clap

By Josh Bloom — Dec 28, 2015
Dame Sally Davies, Britain's chief medical officer, has written to pharmacies and GPs warning them to use correct medical practices when treating the sexually transmitted bacterial infection gonorrhea, but too late Somehow, the UK ended up getting three years behind us in treating the infection properly. This is no laughing matter. Thanks to bacterial resistance, we are now down to one drug that still cures the infection. Misusing it, as was done in the UK, will accelerate the resistance problem, and could leave us with no options to cure a very common STD.

Screen Shot 2015-12-28 at 12.03.45 PMEveryone knows that Britain is in a different time zone from the US. Right now, that difference is supposed to be five hours, but someone obviously forgot to tell the country's National Health Service (NHS), because they are more like three years behind us when it comes to treating gonorrhea aka, "the clap."

This became evident recently when BBC News reported that Dame Sally Davies, Britain's chief medical officer, had written to pharmacies and GPs warning them to use correct medical practices when treating this infection, because we are down to one drug, ceftriaxone, that is still effective against the infection, which is caused by the bacterium Neisseria gonorrhoeae. Just in time.

As I wrote in the New York Post in 2012, ceftriaxone must now be given by injection only (usually combined with an oral course of Zithromax) to ensure that the infected patient gets the entire dose of the antibiotic. This is important because stopping antibiotics partway through therapy is one of many ways of promoting bacterial resistance. Certain strains of gonorrhea are already resistant to ceftriaxone, so administering the drug properly can only slow down the resistance not stop it, but administering it improperly is simply foolish. Once ceftriaxone stops working, it will be difficult, or even impossible to treat gonorrhea a very common sexually transmitted infection that was once easily curable by using simple antibiotics, such as penicillin or tetracycline.

(Zithromax serves two purposes: one is to "help" the ceftriaxone, especially if there are strains present that are resistant to it. The other is to treat chlamydia infection, which is frequently found in people who have gonorrhea.)

Dame Davies sure needed to speak up, perhaps sooner, because the treatment of gonorrhea in the UK has been pathetic. For example, some doctors were still prescribing Cipro, even though it stopped working years ago, while others were using ceftriaxone pills, or Zithromax alone both no no's.

As if more bad news is needed, the number of cases of gonorrhea and other STDs is steeply rising. Paradoxically, this is because AIDS drugs are so good that when used properly, transmission can be cut to near zero, which allows gay men to forgo condoms, which, of course, facilitates the spread of other STDs. What a mess.

Perhaps Britain will set Big Ben ahead by three years and catch up to its "more accurate" little brother in Grand Central Station. Time's a wastin.

Josh Bloom

Director of Chemical and Pharmaceutical Science

Dr. Josh Bloom, the Director of Chemical and Pharmaceutical Science, comes from the world of drug discovery, where he did research for more than 20 years. He holds a Ph.D. in chemistry.

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