Gonorrhea, a sexually transmitted disease caused by the bacteria Neisseria gonorrhoeae, has long been a challenge to treat due to its ability to develop drug resistance. However, recent developments have brought two new treatment options to the table: zoliflodacin and gepotidacin.
In December, the U.S. Food and Drug Administration approved these oral medications for the treatment of gonorrhea infections of the urethra or cervix that have not spread elsewhere in the body. This is a significant development, as there haven’t been new antibiotics for Neisseria gonorrhoeae in decades, and the pathogen has shown resistance to many classes of antibiotics, including the current mainstay, ceftriaxone.
The approval of zoliflodacin and gepotidacin comes at a critical time, as gonorrhea infections are on the rise globally. In 2020, an estimated 82 million new cases were reported worldwide, with approximately 1.5 million new infections occurring each year in the United States alone.
A phase 3 clinical trial of zoliflodacin, published in the Lancet, found that the drug was as effective as ceftriaxone plus azithromycin in eradicating the bacteria in study participants. Zoliflodacin works by blocking a protein that bacteria need to function and reproduce.
Similarly, a phase 3 trial of gepotidacin, also reported in the Lancet, showed promising results for the treatment of gonorrhea. This antibiotic, which inhibits bacterial replication of genetic material, performed similarly to the standard treatment of ceftriaxone plus azithromycin. Both zoliflodacin and gepotidacin were found to be well-tolerated, with common side effects including headaches and nausea.
While the trials showed promising results, a better understanding of how these antibiotics work in women is still needed. The trials had a low representation of women, with only 12 percent in the zoliflodacin trial and 8 percent in the gepotidacin trial.
Overall, the approval of zoliflodacin and gepotidacin provides new hope in the fight against drug-resistant gonorrhea. These new treatment options offer a ray of light in the battle against this challenging infection, and further research is needed to fully understand their efficacy, particularly in women. Are you passionate about science and looking to enhance your commitment to the field in 2026? Join the Society for Science today and make a difference in scientific literacy. As the publisher of Science News, the Society for Science is dedicated to providing independent journalism, free STEM education resources, and hosting world-class science competitions.
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