Super Gonorrhea May Be Spreading From Antibiotic Overuse For Covid-19 Coronavirus

You want 2021 to be super. But not in a super gonorrhea type of way.

“Super gonorrhea” is trending on Twitter right now because, well, why not? It’s 2020, after all. And what better thing to have trend at the end of a year that brought us the Covid-19 coronavirus pandemic, a shortage of basically everything, constant drama in the White House, and a Presidential election that just won’t end? Consider this sexually transmitted infection to be the pie à la mode, the night cap, the final wipe of 2020.

If you haven’t figured it out yet, super gonorrhea is not super to have. It won’t prompt you to tell your partner, “I just returned from the doctor’s office, and I’ve got super news for you.” Nah, telling him or her that you have super gonorrhea would be about as positive as saying that you have sexy syphilis or candy-coated chlamydia. Super gonorrhea isn’t a comic book hero either, in case you are wondering:

If it were made into a film, super gonorrhea could give Ghost Rider a run for worst comic book movie ever.

Instead, super gonorrhea results 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 back in 2017 for Forbes, the World Health Organization (WHO) listed such strains of N. gonorrhoeae on its world’s most dangerous superbugs list. When making your bucket list, don’t include anything on this WHO superbug list. “We’ve run out of ways to treat your infection,” ranks up there with “no one can fly the airplane” in the list of things that you don’t want to hear.

Then in 2018, I covered for Forbes a case of a man from the U.S. who had had a “super” sexual encounter while traveling in Southeast Asia. The man developed symptoms a month later and was diagnosed with super gonorrhea. As a result, the man’s regular partner in the U.K. had to get tested but ended testing negative for the superbug. Imagine the conversation that could have occurred there. “Well, you did have sex with someone else while traveling, you caught gonorrhea, and it was super gonorrhea, but at least, you didn’t pass it to me,” would be looking at the glass as half-full.

So why is super gonorrhea trending on Twitter when there are oh so many other things that can trend? Well, some in the Twittersphere have offered possible explanations:

But it looks like it stemmed from a WHO spokesperson telling The Sun that the overuse of azithromycin and the lack of services to treat sexually transmitted infections (STIs) during the Covid-19 coronavirus pandemic may be fueling the rise of super gonorrhea. Not the Sun as in that fiery ball in the sky but The Sun as in the U.K. publication.

Indeed, the use azithromycin can select for more resistant versions of gonorrhea. Remember earlier this year when some were touting the use azithromycin along with hydroxychloroquine to treat Covid-19? This was even before well-constructed and executed clinical studies were done to assess the safety and efficacy of such medications for treating severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infections. Since then clinical studies have not found enough evidence to support such use. As a result the National Institutes of Health (NIH) Covid-19 Treatment Guidelines Panel now “recommends against the use of chloroquine or hydroxychloroquine with or without azithromycin for the treatment of Covid-19” in hospitalized or non-hospitalized patients.

For everyone who may have said, “what’s the harm in continuing to use azithromycin to treat SARS-CoV2 infections,” when few alternatives existed, well here’s a super response. Using antibiotics indiscriminately on everything as if they were Nutella can select for resistant organisms. Antibiotics like azithromycin are considered “broad spectrum” because they can kill or inactivate a wide range of different bacteria. That can be helpful when you don’t know what is causing an infection or when there is no other option. However, every time you use a broad spectrum antibiotic rather than one a lot more specific to what you trying to treat, such an antibiotic may wipe out the weaker versions of a bacteria, leaving the stronger more resistant ones. The remaining stronger ones then multiply and become a lot more predominant. This is how more resistant versions of the bacteria take over and spread.

One problem with the Covid-19 coronavirus pandemic is that other pathogens haven’t necessarily taken a break. They haven’t spent most of their time on Zoom calls muting each other and using the video filters while saying, “hey look at me, herpes with a hat.” While humans social distancing 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, it has also reduced the availability of doctors to properly treat STIs. The pandemic has shut down many “non-essential” health services or dissuading many patients from seeking proper medical care. Therefore, people may be running around with untreated infections or trying to self-treat with potentially inappropriate antibiotics.

As I’ve said repeatedly, the Covid-19 coronavirus pandemic has been exposing many of the problems that have already existed in society. Antibiotic-resistant bacteria is one of them. If nothing is done to better tackle this looming problem, pathogens like super gonorrhea will be far from gone baby gone in 2021 and beyond.

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