The STD superbug

 

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For the last 60 years, we have enjoyed a period where most infections have been easy to treat. That time could be coming to an end.

I should know, I’ve worked in the area of antimicrobial drug resistance. It’s a constant race with the bugs. We develop a new antibiotic, and after a while, we see the first signs of resistance appearing. Then the resistance spreads, until finally that antibiotic becomes useless. Then it’s time to move to the next antibiotic, if one exists. Earlier this month the Herald reported that this is happening with Neisseria gonorrhoeae, the cause of gonorrhoea. And there are no more antibiotics left to treat it.

This is a concern because of the poor advice given about STDs. Often STDs are described as being easy to treat or cure. That’s not consistent with the advice about infectious diseases from outside the ‘sexual health’ area. How often do hospitals advise visitors to stay away if they are sick? Yet in the ‘sexual health’ area, the advice is to just use condoms. That would be like the hospital saying, ‘come at visit no matter how much you are coughing and sneezing, just wear a face mask”.

Anyone in public health would see that as irresponsible.

But the ‘just wear a condom’ advice is given particularly to young people who are consistently the worst at using condoms, and who are the most vulnerable to catching STDs.

The rates of gonorrhoea have been dropping for teenagers in NZ, as have been the rates chlamydia and abortions. This could well be because young people are having less sex and fewer partners. It’s a trend that should be encouraged. Living a chaste life is the best protection against all STDs. Not just gonorrhoea. That includes other STDs like HPV, which can continue to spread even with consistent condom use. Chaste living also protects against any STDs that we don’t yet know about.

Fighting microbes isn’t fighting a fixed target. New species of microbes turn up from time to time. New strains of the old bugs emerge all the time. Sometimes more virulent, sometimes less. The one constant feature is that the drugs that we use to treat them become useless in time.

With gonorrhoea, this started with penicillin and tetracycline, and then fluoroquinolones. Ceftriaxone is the last drug left. And last year there were reports of resistance to ceftriaxone in Auckland and Waikato. If one strain acquires high levels of resistance to all these drugs, it will become untreatable. It’s probably only a matter of time before that happens. Then our oldest protection against STDs will become our only protection: Chastity.

So why are there no more antibiotics left? One of the main reasons is economics. It costs a great deal of money to develop any drug. If the drug is a contraceptive, and going to be used daily for decades, the drug company can get its development costs back. If it’s an antibiotic, and only going to be used for a 2 week course, the chances are recovering development costs aren’t very good. So the forces that rubbish chastity and push contraceptives onto our society are the same forces that tolerate the harm done when a chaste life is abandoned.

It’s called the culture of death.

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