New Antibiotic to Treat Gonorrhea Advances in Trials


Health Editor’s Note: Bacteria that cannot be killed with the antibiotics that used to kill them put mankind on a slippery slope with definitive treatments becoming less to non-existent effective. Gonorrhea is only one of several types of bacteria which no longer respond to regimes of antibiotics. To fight these bacteria means there must be new ways to adversely effect bacteria. The medical community must dig deeper into its bag of tricks…Carol

Written by U.S. Department of Health and Human Services/National Institutes of Health Research Matters

At a Glance

  • A novel antibiotic called zoliflodacin cured most gonorrhea infections in a single dose.
  • The findings pave the way for larger, more definitive trials.

In recent years, the sexually transmitted disease known as gonorrhea has become more common. Last year, more than 550,000 people were diagnosed in the U.S. The bacterium that causes this infection, Neisseria gonorrhoeae, is becoming harder to treat. More people are developing infections that are resistant to multiple classes of antibiotics. If not cured, gonorrhea can cause infertility and other problems.

To combat this public health threat, scientists have been searching for compounds that kill the bacterium by novel mechanisms. They discovered a new type of antibiotic called zoliflodacin that can inhibit the bacterium’s DNA synthesis in a different way than current antibiotics.

A research team led by Dr. Stephanie N. Taylor of Louisiana State University Health Sciences Center tested zoliflodacin in people with gonorrhea. Their trial was designed to evaluate the drug’s safety and assess whether to proceed to larger studies. The trial was supported by NIH’s National Institute of Allergy and Infectious Diseases (NIAID). Results were published on November 8, 2018, in the New England Journal of Medicine.

The investigators recruited men and women, ages 18 to 55, from sexual health clinics in several U.S. cities. Participants either had untreated genital gonorrhea, signs and symptoms of gonorrhea, or a sexual partner with gonorrhea. They were randomly assigned to receive either 2 grams or 3 grams of zoliflodacin by mouth, or 500 milligrams of ceftriaxone, a currently recommended antibiotic, by injection.

About one week after treatment, nearly all of the gonorrhea infections of the genitals were cured: 48 of 49 people (98%) who received 2 grams of zoliflodacin, all 47 people who received 3 grams, and all 21 people who got ceftriaxone. Similarly, all 13 rectal infections were cured no matter which treatment the person received.

However, throat infections were more persistent. Throat infections were cured in 4 of 6 people (67%) receiving 2 grams of zoliflodacin and 7 of 9 people (78%) receiving 3 grams. All 4 people in the ceftriaxone group were cured.

Participants were asked about side effects. Overall, the people tolerated both types of treatment well. A mild upset stomach was the most common side effect.

“The rate of reported gonorrhea cases in the United States has increased 75% since the historic low in 2009, and antibiotic resistance has considerably reduced the number of treatment options for this disease,” says NIAID Director Dr. Anthony S. Fauci. “These encouraging research findings published today suggest that zoliflodacin has the potential to be a useful and easy-to-administer oral antibiotic for treating gonorrhea.”

The FDA awarded zoliflodacin with fast track status for development as an oral treatment for gonorrhea. Plans are now underway for testing in the U.S., Netherlands, South Africa, and Thailand.

Related Links

References: Single-Dose Zoliflodacin (ETX0914) for Treatment of Urogenital Gonorrhea. Taylor SN, Marrazzo J, Batteiger BE, Hook EW 3rd, Seña AC, Long J, Wierzbicki MR, Kwak H, Johnson SM, Lawrence K, Mueller J. N Engl J Med. 2018 Nov 8;379(19):1835-1845. doi: 10.1056/NEJMoa1706988. PMID: 30403954.

Funding: NIH’s National Institute of Allergy and Infectious Diseases (NIAID) and Entasis Therapeutics.


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  1. The U.S. is still a very backward country when it comes to informing ignorant members of the public the dangers of exposure to venereal diseases mainly through sexual contact. The fact that drugs have been over used is proof itself of this failure to inform. With all the modern means of communication where have the authorities been to educate the public on the well known dangers of these ancient diseases? Many of those involved should be fired. When I was a teenager growing up in a small town in California a doctor and nurse came to the local theater. After the regular program the lights came on and both, who were immaculately dressed in white suites, discussed the subject they were going to address and gave everyone who so desired a chance to leave since this would be a controversial subject then and now. Then they showed graphic films of the horrible consequences of syphilis and gonorrhea. A picture is worth a thousand words. They showed the three stages of syphilis ending in a horrible death. After the films the lights came on and they answered any questions professionally. So far as I know they did this on their own as a public service. Today there are many other ways such as videos which could address this problem. How often do you read of a doctor or nurse giving a talk at a local church or civic hall on this subject? Almost never. Even if new drugs are developed, they will also become obsolete too due to the promotion of sex from the Hollywood Perverts …

    • … Hollywood Perverts and elsewhere. Promiscuity among teenagers and adults in our society is at record levels. Ignorant people think there are no consequences for these horrible diseases.The authorities must address this massive public relations problem. Frankly these issues must be talked about openly and honestly everywhere in our society if we are to survive as a civilization. We are living in the dark ages in the U.S. today when it comes to sex education and venereal disease education among the public. This is all a shameful disgrace in this day and time. The military has been showing graphic films on these subjects for decades. Why not civil society too?

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