STD Pill Doesn't Always Work

Medicines containing cefixime fail to cure 7 percent of gonorrhea cases

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Compared to shots or taking pills up the other end, swallowing medicine is often the option of choice. But oral meds for a certain sexual disease may be out of the question.

Cefixime, which was the only oral antibiotic treatment recommended for gonorrhea, may not work all the time.

This limits options for treating the disease and pushes researchers to find other means to cure the problem.

"Have new sexual partners tested."

Last August, the Centers for Disease Control announced they no longer recommend cefixime, commonly known as Suprax. Researchers, led by Vanessa Allen, MD, MPH, from the Public Health Ontario Laboratories, aimed to see how often the treatment failed to work.

The study included 291 people who tested positive for gonorrhea and were treated with cefixime. Patients were tested at a sexual heath clinic in Toronto, Canada between May 2010 and April 2011.

The clinic tested for the STD using a culture-based method involving chemicals and probes. Patients were required to come in two weeks to a month later for a follow-up test, all which followed guidelines set by the Public Health Agency of Canada.

Researchers recorded why patients came in to be tested, where they were infected, and whether they had any other infections related to the STD. They also gathered patients' gender, age and sexual orientation.

In total, 13 patients still tested positive for gonorrhea after being treated, nine of whom had taken cefixime, researchers found.

Four out of 76 still had the STD inside their urethra after taking cefixime. Two of the seven with infections in their throats were still infected, as well as three of the 39 infected in the rectum.

Overall, the drug failed about 7 percent of the time. Among the nine failed cases, seven had a dosage of less than 0.12 micrograms per milliliter of cefixime.

The failed cases were successfully treated later on with a ceftriaxone shot or a larger dose of cefixime.

"In light of the increases in cefixime MICs among isolates of N. gonorrhoeae across North America, this study offers preliminary clinical data to support the recent CDC recommendations that cefixime is no longer optimal first-line therapy for the successful treatment of gonorrhea," researchers wrote in their report.

The authors noted that most of the patients at their study clinic were those who had male-to-male sexual contact. In addition, six of the nine failed treatments had also received another medication with the cefixime, which may have skewed results.

The study was published January 9 in JAMA. No conflicts of interest were reported and funding information was not available.

Reviewed by: 
Review Date: 
January 10, 2013
Last Updated:
January 13, 2013