The end of the era of antibiotics

The CDC, not known for hysteria, stated the danger starkly: “Untreatable gonorrhea may become a reality in the U.S.’’

Gonorrhea is already fairly common in America, with more than 700,000 new infections annually. If untreated in women, it can lead to pelvic inflammatory disease, and even infertility. Men, too, can be left infertile. Gonorrhea can also spread to the blood. It can be fatal.

We can hope for a new medicine, but antibiotic development is not an area of great interest to Big Pharma. And if nobody devises a new treatment regimen in time, then gonorrhea will become super-gonorrhea. The number of cases will explode, and the vicious complications will move from rare to common. A scourge would come roaring back.

How did this happen? The driving forces are Darwin and human carelessness. Bacteria are constantly evolving, adapting to the changing conditions they face. Antibiotics usually kill bacteria. But sometimes a bacteria will develop a biological defense - particularly if too small a dose is used. Gonorrhea bacteria have proven especially adept at developing defenses, for reasons that remain mysterious.

But we have also hastened gonorrhea’s progress, says Dr. Stuart Levy, a professor at the Tufts University School of Medicine and president of the “Alliance for the Prudent Use of Antibiotics.’’ There was a time when penicillin, the original miracle drug, would cure gonorrhea. But it was not used carefully, and eventually, in brothels during the Vietnam war, a resistant strain arose and spread around the globe.

In many parts of the world, antibiotics are available without a prescription, which means that they are widely misused, giving our invisible enemies more chances to develop resistance.