Chlamydia and Gonorrhea – Emerging Antibiotic Resistance

February 1, 2021

When Alexander Fleming discovered penicillin in 1928, it would soon be hailed as a “wonder drug,” because so many bacterial diseases were successfully treated with it. The list includes:

  • Bacterial pneumonia
  • Strep throat
  • Scarlet fever
  • Diphtheria
  • Syphilis
  • Gonorrhea
  • Meningitis
  • Tonsillitis
  • Rheumatic fever

and many more.

Dr. Fleming made a prediction which, unfortunately, came true. He predicted that bacteria would evolve resistance to the new wonder drug, and by 1952 strains of resistant bacteria were causing disease. Since then new generations of penicillins and other families of antibiotics have been developed. Each time a new antibiotic is developed there is generally speaking a finite number of times it can be used before the bacteria develop resistance, so there is an ongoing battle between the scientists and the bacteria.

Penicillin lost its effectiveness against Gonorrhea during the 1980’s, and it is no longer used to treat the disease. During the 1990’s antibiotics known as fluoroquinolones were prescribed, but the bacteria soon evolved resistance to them as well. By 2007 the Centers for Disease Control and Prevention (CDC) recommended using cefixime (oral tablet) or  ceftriaxone (an injection). In 2010 the CDC recommended use of either Suprax (cefixime) or Rocephin (ceftriaxone), along with either of two other antibiotics, Zithromax (azithromycin) or Vibramycin (doxycycline) to treat a possible co-infection with Chlamydia. Two years later Gonorrhea showed some resistance to cefixime. Now the recommendation is an injection of ceftriaxone along with oral azithromycin. Resistance to azithromycin has been seen in the United States, and resistant bacteria have been detected in Asia. Soon new antibiotics will be needed against Gonorrhea.

So far Chlamydia has been much easier to treat. Azithromycin is taken in a dose of 1 gram once, or doxycycline can be taken in a dose of 2 tablets per day for one to two week(s). This could change in the near future. Resistance to tetracycline (doxycycline) has been demonstrated in Chlamydia isolated from pigs. In July of 2020 Elsevier Journal of Infectious Diseases reported a study in which resistance to azithromycin was seen in certain genetic strains of Chlamydia.

Everyone can help keep the number of resistant strains low by avoiding changing partners often, and using condoms.


Did you know? QuickMD can treat Chlamydia and Gonorrhea from the comfort and privacy of your home, and prescribe you antibiotics online without the need to go to a clinic. You can also order your own STD test at a discounted price here.

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