Drug-resistant sex disease sparks alarm

A jump in drug-resistant gonorrhoea among gay and bisexual men has prompted United States health officials to recommend that the antibiotics usually used to treat the sexual infection be avoided in some cases.

The Centres for Disease Control and Prevention advised doctors to stop prescribing ciprofloxacin and other fluoroquinolones as a first-line treatment for men who likely have contracted gonorrhoea from other men.

The recommendation to limit use of fluoroquinolones, which are relatively inexpensive and administered in a single oral dose to cure gonorrhoea, could complicate the nation's efforts to combat sexually transmitted diseases in high-risk groups.

Ceftriaxone and spectinomycin, the drugs now recommended for gonorrhoea infections in gay and bisexual men and some heterosexuals, require injection.

The agency said these drugs should also not be used for heterosexuals who had been infected in Asia, the Pacific Islands, California, parts of Britain and other areas where drug-resistance gonorrhoea is more prevalent.

Gonorrhoea, which made a comeback in the US in the late 1990s after two decades of steady decline, can cause chronic pelvic pain, infertility and arthritis if left untreated. It also facilitates the spread of the Aids virus.

Although the majority of the estimated 700,000 to 800,000 Americans infected each year are heterosexuals, there is heightened concern about the resurgence of the disease among men who have sex with men.

Almost 5 per cent of gay and bisexual men infected last year were resistant to fluoroquinolones, about three times more than in 2002, according to a CDC study from 23 US cities.

The incidence of drug resistance in heterosexual men with gonorrhoea doubled to 0.4 per cent last year, researchers said in the study.

Data from New York and Massachusetts also found much higher drug resistance - up to eight times that of heterosexual men - in gay and bisexual men with the infection.

CDC officials said a more-relaxed attitude to safe sex, the use of some illicit drugs before sex and the growing practice of finding sex partners on the internet were factors that likely contributed to the alarming data.

Dr John Douglas, director of the agency's STD prevention programmes, speculated that travellers returning from parts of the world where drug-resistant gonorrhoea was more endemic were helping to fuel the rising trend.

- REUTERS