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Gonorrhoea often prescribed ineffective drugs

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Patients with gonorrhoea given ineffective meds Patients with gonorrhoea are often given ineffective medication

Many UK patients with gonorrhoea are being prescribed antibiotics that are no longer recommended for treating the infection by a healthcare professional, reveals research published in the BMJ Open.

The researchers expressed concerns that healthcare professionals are not keeping up with national clinical guidance, given that there is a global threat of antibiotic resistance.

They based their findings on any analysis of electronic health records entered anonymously into the Clinical Practice Research Datalink (a large database containing the health records of around 5.5million patients registered with 680 general practices around the UK) as well as information from anonymous monitoring of sexually transmitted infections.

The researchers looked at how doctors in general practice had treated chlamydia and gonorrhoea, the two most commonly diagnosed bacterial sexually transmitted infections in England between 2000 and 2011.

Healthcare professionals diagnosed an estimated 193,000 people with chlamydia and nearly 17,000 with gonorrhoea in this period. 90% of chlamydia diagnoses were prescribed an antibiotic recommended in the national clinical guidance, but this was not the case for gonorrhoea. Although ciprofloxacin was discontinued as a recommended treatment in 2005 it accounted for 42% of precriptions in 2007 and one in five in 2011.

The researchers conclude that GPs make an important contribution to the diagnosis and treatment of bacterial sexually transmitted infections, but while most patients with chlamydia are treated appropriately, "significant numbers" of those infected with gonorrhoea are not.

'Treatment of infections with reduced susceptibility or resistance to the prescribed therapy may inadvertently facilitate onward transmission and risks infection complications,' they said.

'Antimicrobial resistance in gonorrhoea is a global problem and may become an issue for chlamydia in future,' they warn. 'Practitioners should be alert to the likelihood of revisions to national treatment guidelines and of treatment failure in their patients.'

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