New Antibiotic May Be Effective in Treating Gonorrhea

TUESDAY, April 15, 2025 (HealthDay News) — A newly approved antibiotic to treat urinary tract infections may also help fight drug-resistant gonorrhea, a new study shows.

The medication, called gepotidacin, could become the first new gonorrhea treatment since the 1990s. In an international study of more than 600 people, researchers found that it worked just as well as current standard treatments.

“Gepotidacin is a novel oral antibacterial treatment with the potential to become an alternative option for the treatment of gonococcal infections, supported by an acceptable safety and tolerability profile,” the researchers wrote April 14 in The Lancet.

Gepotidacin works by stopping bacteria from multiplying. The U.S. Food and Drug Administration (FDA) approved the drug in March to treat urinary tract infections (UTI) in females age 12 and up. The rise of drug-resistant UTIs has made new treatments necessary, CNN reported.

This latest study looked at how well gepotidacin works against gonorrhea, a common sexually transmitted infection (STI) that has become harder to treat due to antibiotic resistance.

The study included people from the U.S., Australia, Germany, Mexico, Spain and the U.K. Half received two oral doses of gepotidacin, 10 to 12 hours apart. The other half received a shot of the antibiotic ceftriaxone plus an oral dose of azithromycin.

Cure rates were similar — 92.6% in the gepotidacin group and 91.2% in the group given ceftriaxone plus azithromycin.

While 88% of participants with gonorrhea of the throat had a harder time clearing the infection, most were successfully treated.

“The big takeaway is that having additional treatment options for gonorrhea is fantastic,” Dr. Jason Zucker, an infectious disease and sexually transmitted infections expert who was not involved in the new study, told CNN.

“Right now, patients come in, especially if they are not having symptoms, if they test positive, we have to ask them to come back. For some people, that’s not so easy,” he said. “So obviously, the ability to have the pharmacy send treatment to their house, or have them be able to pick it up, would really make things a lot easier for people and reduce the number of doctor visits they have, especially if they have jobs where they don’t have a lot of time off.”

Dr. Jeffrey Klausner, a professor of public health at the University of Southern California, welcomed the findings.

“The more options doctors have to treat gonorrhea means that they do not have to use the same drug over and over again, which is a recipe for disaster and more resistance,” Klausner said in an email to CNN. “If gepotidacin is approved and recommended for gonorrhea treatment, that is a true advance and will greatly help our efforts to slow down drug resistance in gonorrhea.”

The drug did cause mild or moderate side effects, mostly nausea and diarrhea, the study said.

Researchers said more work is needed to better understand how well gepotidacin works, especially in groups that were not well represented in the trial, including women and people of color.

In an accompanying commentary, two European experts warned that gonorrhea bacteria may eventually become resistant to gepotidacin, too.

"Due to the inherent ability of gonococci to develop resistance, difficulties in increasing the gepotidacin dose due to adverse events, and the lack of other treatment options, preclinical and clinical development of additional gonorrhoea treatments remains important,” Magnus Unemo of Örebro University in Sweden and Teodora Wi of the World Health Organization (WHO) in Switzerland wrote.

“In conclusion, gepotidacin is promising for the treatment of gonorrhoea, but the challenges to retain gonorrhea as a treatable infection will continue,” they concluded.

More information

The Mayo Clinic has more on gonorrhea.

SOURCES: CNN, April 14, 2025; The Lancet, April 14, 2025