Supergonorrhea may be spreading by overuse of antibiotics for Covid-19 Coronavirus

You want 2021 to be excellent. But not in a supergonorous way.

“Super gonorrhea” is on the rise on Twitter now because, well, why not? After all, we are in 2020. And what better thing to have a trend at the end of a year that brought us the Covid-19 coronavirus pandemic, a scarcity of basically everything, constant drama in the White House and a presidential election that just won’t end? Consider this sexually transmitted infection as pie à la mode, the end of the night, the final cleansing of 2020.

If you haven’t figured it out yet, it’s not good to have supergonorrhea. It won’t make you say to your partner, “I just got back from the doctor’s office and I have great news for you.” Nah, telling him that you have supergonorrhea would be as positive as saying that you have sexy syphilis or candy-coated chlamydia. Supergonorrhea is also not a comic book hero, in case you’re wondering:

If it were presented in a film, supergonorrhea would Ghost Rider a race for the worst comic book movie of all time.

Instead, supergonorrhea occurs when the bacteria that causes gonorrhea, Neisseria gonorrhoeae, develops a high level of resistance to the antibiotics normally used to treat the infection: azithromycin and ceftriaxone. As I reported in 2017 for Forbes, the World Health Organization (WHO) has listed these strains of N. gonorrhoeae on the list of the most dangerous superbugs in the world. When making your bucket list, do not include anything on this list of WHO superbugs. “We ran out of ways to treat your infection,” it classifies there with “no one can fly the plane” or “the hull of the cruise ship you’re on is made of pickles” on the list of things you don’t want to hear.

So, in 2018, I covered Forbes a case of a man from the United Kingdom (UK) who had a “super” sexual encounter during a trip to Southeast Asia. The man developed symptoms a month later and was diagnosed with supergonorrhea. As a result, the man’s regular partner in the UK had to get tested, but she happily tested negative for the superbug. It is not clear whether this couple stayed together after the super reveal. After all, things like not knowing how to dance the tango or infecting you with supergonorrhea can be an obstacle for some when it comes to dating. If the relationship continued, the woman would have quite a card to raise in future arguments such as, “what don’t you take out of the trash? Well, remember that time you had sex with someone else and you almost gave me a supergonorrhea? ”

So why is supergonorrhea on the rise when there are so many other things that can be trending? Well, there are different possibilities:

But it looks like the trend came from a WHO spokesman saying The sun that the overuse of azithromycin and the lack of services to treat sexually transmitted infections (STDs) during the Covid-19 coronavirus pandemic may be fueling the increase in supergonorrhea. Not the Sun like that fireball in the sky that you shouldn’t look at even during an eclipse, but The sun as in the UK publication.

In fact, using azithromycin more often can select more resistant versions of N. gonorrhoeae. Do you remember earlier this year, when some were publicizing the use of azithromycin along with hydroxychloroquine to treat Covid-19? And have some political leaders joined this movement? This was even before well-constructed and performed clinical studies to evaluate the safety and efficacy of such drugs in the treatment of severe infections of the acute respiratory syndrome of coronavirus 2 (SARS-CoV2). So this was an example of premature medication. Since then, clinical studies have not found enough evidence to support this use. In a comment on O Lancet, Catherine E. Oldenburg, PhD, assistant professor and Thuy Doan, MD, PhD, associate professor at the University of California, San Francisco, (UCSF) concluded “for patients with Covid-19, the addition of azithromycin to the existing standard of regimens treatment does not seem to improve results ”, after reviewing the results of the COALITION II study that evaluated the addition of azithromycin to hydroxychloroquine and the standard of care to treat hospitalized patients with severe Covid-19.

As a result of the scientific evidence that emerged later, the Covid-19 Treatment Guidelines Panel of the National Institutes of Health (NIH) now “recommends against the use of chloroquine or hydroxychloroquine with or without azithromycin for the treatment of Covid-19” in patients hospitalized or out-of-hospital patients.

For everyone who may have said, “What’s wrong with continuing to use azithromycin to treat SARS-CoV2 infections”, well, here’s a super answer. The indiscriminate use of antibiotics in infectious diseases as if the drugs were Nutella can stimulate the growth of resistant organisms. Antibiotics such as azithromycin are considered “broad spectrum” because they can kill or inactivate a wide range of different bacteria. It’s like using a bomb instead of a rifle. This can be useful when you don’t know what is causing the infection or when there is no other option.

However, each time you use a broad-spectrum antibiotic instead of a treatment that is much more targeted and specific, you risk eliminating friendlier bacteria and weaker versions of a pathogen like N. gonorrhoeae, leaving the stronger and more resistant versions, a more open field to flourish. The rest, stronger, then multiply and become much more prevalent. This is how more resistant versions of the bacteria take over and spread.

In the USA, the five years of 2013 to 2018 saw a jump of more than seven times in the percentage of N. gonorrhoeae samples less susceptible to azithromycin from 0.6% to 4.6%. Increased resistance to azithromycin in N. gonorrhoeae led to a change on December 18 in the guidelines of the Centers for Disease Control and Prevention (CDC) for the treatment of uncomplicated gonorrhea. Instead of a two-drug approach with azithromycin and ceftriaxone, the CDC now recommends only one injection of 500 mg of ceftriaxone. By “uncomplicated”, the CDC means your common gonorrhea infections, number one, your urinary tract, number two, your rectum, genital areas or throat. If you don’t know how each of these places can be affected by N. gonorrhoeae, you may need to redo sex education. Obviously, more complicated gonorrhea may require antibiotics.

One problem with the Covid-19 coronavirus pandemic is that other pathogens have not necessarily taken a break. They didn’t spend most of their time on calls from Zoom, silencing each other and using the video filters while saying, “look at me, herpes with a hat”. While the social distance from humans may have limited the spread of some pathogens, such as influenza, others may have had a good 2020.

After all, the pandemic has not only prompted doctors to try different antibiotics to treat Covid-19 coronavirus, but it has also reduced the availability of doctors to treat STIs properly. The pandemic has closed many “non-essential” health services or has deterred many patients from seeking adequate medical care. Therefore, people may be running with untreated infections or trying to treat themselves with potentially inappropriate antibiotics.

As I said several times, the Covid-19 coronavirus pandemic has exposed many of the problems that already existed in society. The antibiotic-resistant bacteria is one of them. If nothing is done to better deal with this impending problem, pathogens such as supergonorrhea will be far from disappearing in 2021 and beyond.