New antibiotic for gonorrhoea on trial

A novel single-dose oral antibiotic (zoliflodacin) has been shown to be effective against gonorrhoea infections. In a study published in the New England Journal of Medicine (doi.10.1056/NEJMoa1706988) trialists randomly assigned 179 men and women with signs or symptoms of uncomplicated urogenital gonorrhoea to a single oral dose of zoliflodacin (2g or 3g) or a single 500mg intramuscular dose of ceftriaxone.

Microbiologic cure at urogenital sites was seen in 55 of 57 (96%) who received 2g of zoliflodacin, 54 of 56 (96%) who received 3g of zoliflodacin, and 28 of 28 (100%) who received ceftriaxone. Zoliflodacin was less effective against pharyngeal infections with only 4 of 8 participants (50%) and 9 of 11 participants (82%) in the 2g and 3g groups respectively being cured, compared to 4 of 4 (100%) in the ceftriaxone group.

The new antibiotic was generally well tolerated, with gastrointestinal adverse effects being the most frequent.

Widespread antibiotic-resistant Neisseria gonorrhoeae has prompted the need for new antibiotics. Zoliflodacin acts on the DNA synthesis, inhibiting it in a different way than current antibiotics. Further trials will hope to establish the drug as a valuable addition in the fight against a growing problem.

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