The recommended treatment of sexually transmitted infections, revised taking into account the increasing levels of antibiotic resistance
WHO issues new guidelines for the treatment of chlamydia, gonorrhea and syphilis
In response to the growing threat of antibiotic resistance, the world health organization (who) has issued new guidelines for the treatment of three common sexually transmitted infections.
Chlamydia, gonorrhea, and syphilis are all infections caused by bacteria that are usually treated with antibiotics. However, these STIs are often undiagnosed and increasingly difficult to treat, as some antibiotics have lost their effectiveness as a result of their misuse or overuse. An estimated 131 million people get chlamydia, 78 million get gonorrhea, and 5.6 million get syphilis every year.
In recent years, the resistance of these STIs to antibiotics has rapidly increased and the choice of treatment options has narrowed. Among these STIs the highest resistance to antibiotics developed in Neisseria gonorrhoeae. Multiple drug-resistant strains of gonococci that do not respond to any available antibiotics have already been identified. In the case of chlamydia and syphilis, antibiotic resistance is also observed, although to a lesser extent, and this threatens prevention and rapid treatment.
STIs that are not detected and treated can lead to serious complications and long-term health problems in women, such as pelvic inflammatory disease, ectopic pregnancy and miscarriage, and gonorrhea and chlamydia, if left untreated, can lead to infertility in both men and women. Chlamydia, gonorrhea, and syphilis can also increase the risk of HIV infection by two to three times. An untreated STI in a pregnant woman increases the likelihood of stillbirth and death of a newborn baby.
“Chlamydia, gonorrhea and syphilis are significant public health problems around the world – they affect the quality of life of millions of people, causing serious illness and sometimes leading to death. New WHO guidelines emphasize the need for timely treatment of these STIs with appropriate antibiotics in the right doses to limit their spread and improve sexual and reproductive health. To do this, national health services need to monitor models of antibiotic resistance in these infections in their countries,” said Ian Askew, Director of the WHO Department of Reproductive Health and Research.
The new recommendations are based on the latest available evidence on the most effective drugs to treat these three sexually transmitted infections.
Transmitted infections: Gonorrhea
Gonorrhea is a common STI that can lead to infection of the genitals, rectum and throat. With the advent of each new class of antibiotics for the treatment of gonorrhea, antimicrobial resistance appeared and increased. Due to widespread resistance, older and cheaper antibiotics have lost their effectiveness in treating infection.
due to the increasing threat of antibiotic resistance, who strongly recommends that countries update their national guidelines for the treatment of gonorrhea. national health authorities should monitor the prevalence of resistance to various antibiotics in gonococcal strains circulating in their populations. the new guidance calls on health authorities to recommend that doctors prescribe the antibiotic that is most effective in the context of local resistance models. According to new WHO guidelines, quinolones (a class of antibiotics) are not recommended for the treatment of gonorrhea due to widespread high levels of resistance.
Transmitted infections: Syphilis
Syphilis is spread by contact with a wound on the genitals, anus, rectum, lips and mouth, or from mother to child during pregnancy. infection transmitted to the fetus by a woman with untreated syphilis often leads to fetal death. in 2012, an estimated 143,000 early fetal deaths/stillbirths, 62,000 neonatal deaths and 44,000 preterm births/low birth weight births occurred as a result of mother-to-child transmission of syphilis.
New WHO guidelines strongly recommend the use of a single dose of benzathine penicillin, an injectable antibiotic that a doctor or nurse inserts into the buttock or thigh muscle of an infected patient, to treat syphilis. This is the most effective drug for syphilis, more effective and cheaper than oral antibiotics.
At the sixty-ninth session of the world health assembly in may 2016, benzatin-penicillin was recognized as one of the main medicines, the stocks of which have been significantly lacking over the past few years. The who has received reports of shortage from representatives and service providers at the antenatal care in countries with a high burden of syphilis in the three regions of who. WHO is working with partners to identify countries experiencing shortages of this drug and is helping to monitor the global availability of benzathine penicillin to address differences between national demand and supply of this antibiotic.
Transmitted infections: Chlamydia
Chlamydia is the most common bacterial STI, and people with this infection often have gonorrhea as a co-infection. Symptoms of chlamydia include discharge and a burning sensation when urinating, but in most people the infection is asymptomatic. Even in the absence of symptoms, infection can have negative consequences for the reproductive system.
WHO calls on countries to move immediately to the use of the updated guidelines, in line with the recommendations of the Global Health Sector Strategy on STIs (2016-2021), approved by Governments at the World Health Assembly in May 2016. the new guidelines are also in line with the global action plan on antimicrobial resistance, which was adopted by governments at the world health assembly in may 2015.
When used correctly and consistently, condoms are one of the most effective ways to protect against STIs.