A new potential treatment for gonorrhea has shown promising results in clinical trials, signaling hope for combating the sexually transmitted infection that is increasingly becoming resistant to available antibiotics. The Lancet medical journal recently published successful trial outcomes for a new antibiotic named gepotidacin, marking a significant development as it emerges as one of the first viable gonorrhea treatment candidates since the 1990s.
Gonorrhea remains one of the most common sexually transmitted infections worldwide, with rising infection rates prompting concern. In Canada, cases reached a 30-year high in 2022, tripling over the past decade. This upward trend is compounded by the Neisseria gonorrhoeae bacterium’s growing resistance to existing treatments, threatening to evolve into a superbug. The last effective antibiotic, ceftriaxone, is also showing signs of waning effectiveness, with resistant strains emerging globally.
The study highlighted in The Lancet, and presented at a significant microbiology conference in Vienna, examined gepotidacin, initially developed by pharmaceutical company GSK for treating urinary tract infections. The U.S. Food and Drug Administration recently approved its use for urinary tract infections. The phase 3 clinical trial involved over 600 participants across six countries, testing gepotidacin against the traditional treatment of ceftriaxone combined with azithromycin.
Results indicated that gepotidacin is “non-inferior” to the traditional treatment, with 92.6 percent of participants clearing their infections compared to 91.2 percent in the control group. Side effects were minimal, primarily nausea and diarrhea. While effective for rectal gonorrhea, the drug was less efficacious for throat infections, necessitating further research due to the small sample size.
Alongside gepotidacin, another recent trial demonstrated the efficacy of a single dose of zoliflodacin for treating gonorrhea. Both belong to a novel class of antibiotics with unique mechanisms of action, offering a promising approach to circumvent bacterial resistance. GSK intends to file for U.S. regulatory approval for gepotidacin to treat uncomplicated gonorrhea, with a decision expected by late 2025.
The Bottom Line
The development of gepotidacin offers a glimmer of hope in the fight against drug-resistant gonorrhea, a growing public health concern. With existing treatments becoming less effective, the emergence of new antibiotics could ensure that gonorrhea remains a treatable infection. This is particularly critical as gonorrhea can lead to severe health complications if left untreated, especially in women.
However, experts caution that even with gepotidacin’s promise, the threat of resistance looms. As the new drug becomes more widely used, its effectiveness may eventually diminish, underscoring the need for continued innovation in antibiotic development. This ongoing battle against drug resistance highlights the importance of investment in research and development to stay ahead of evolving bacteria and preserve public health.