Gonorrhoea: Drug Resistance in Australia

Australian Federation of AIDS Organisations (AFAO), 26 June 2018

There has long been concern globally about the potential emergence of drug resistant STIs. In response, the World Health Organisation released new treatment guidelines for three common STIs – chlamydia, gonorrhoea and syphilis – in 2016.

At present, strains resistant to first line treatment of syphilis and chlamydia are not common and not a concern in Australia. There is, however, a growing level of concern about gonorrhoea. This paper therefore focuses on the likelihood and implications of the emergence of drug resistant cases of gonorrhoea in Australia. It also highlights treatment options in Australia and current and emerging strategies for preventing drug resistant gonorrhoea.

Download paper: AFAO Brief – Gonorrhoea – Drug Resistance in Australia – 26 June 2018

Two cases of multi-drug resistant gonorrhoea recently detected in Australia: media release

Professor Brendan Murphy, Commonwealth Chief Medical Officer, Australian Government Department of Health 

17 April 2018

Two cases of multi-drug resistant gonorrhoea have been recently detected in Australia. One case was diagnosed in Western Australia and a second case diagnosed in Queensland. 

Multi-drug resistant strains can be difficult to treat and it is important to prevent further spread.

Evidence suggests that one of the Australian cases acquired their infection in Southeast Asia.

The situation is being closely monitored by public health authorities.

Gonorrhoea ‘super-superbugs’ triple in six months [in Australia]

SMH, 13/02/2018

Cases of a strain of gonorrhoea impervious to an antibiotic have almost tripled in six months, the latest report from the National Alert System for Critical Antimicrobial Resistance (CARAlert) reveals.

The result was a “warning shot across the bow” for doctors and public health officials fighting antibiotic resistance, CARAlert’s senior medical adviser said.

SHINE SA Media Release: Response to the call to ban Diane-35

SHINE SA, issued 13th December 2017

SHINE SA believes everyone should have access to contraceptive choices, and that decisions about contraception are best made in conjunction with a healthcare professional.

Cyproterone acetate pills, commonly known as Diane-35 appear to be associated with a higher risk of deep venous thrombosis (DVT) than levonorgestrel (LNG) containing pills, although the overall risk is still very low for most people.

For those who choose combined pills, we recommend as first choice the pills with lowest risk: those containing levonorgestrel or norethisterone as their progesterone. However, the other progestogen choices, which all carry a small increased risk of DVT compared to LNG, may be utilised if specific added benefits are required. Health professionals can review over time the experience individuals may have with their contraceptive choice.

Cyproterone acetate can be used as treatment for signs of androgenisation in people such as severe acne (involving inflammation or nodularity, or risk of scarring) where prolonged oral antibiotics or local treatment alone have not been successful, or idiopathic hirsutism of mild to moderate degree. The oral contraceptive pill containing cyproterone acetate can also provide effective oral contraception in this patient group.
People who have concerns should seek advice from their doctor before stopping their oral contraceptive pill.

Download Media release (PDF): Response to the call to ban Diane-35 SHINE SA Diane35_13 Dec 17_FS

 

SHINE SA Media Release: Response to ABC report on Long Acting Reversible Contraception (LARCs)

SHINE SA, Issued: 13 December 2017

SHINE SA believes that decisions about contraception should be made in conjunction with a health care professional and that everyone should have access to accurate and unbiased information to enable appropriate informed contraceptive choice.

LARCs (Long Acting Reversible Contraception) including the levonorgestrel IUD1 (Mirena) and the subdermal implant (Implanon NXT) are the most effective reversible methods of contraception available. They have the additional advantage of being long lasting, convenient to use and generally well regarded by most users. LARC method failure rates rival that of tubal sterilization at <1% and unintended pregnancy rates are lower than those reported for contraceptive pill users.

Like all progestogen only contraceptive methods, LARCs may result in a change of bleeding pattern which may include no bleeding, frequent or prolonged bleeding. Users of the levonorgestrel IUD most commonly experience a reduction in bleeding over time and it is used as a treatment for Heavy Menstrual Bleeding for this reason. Only 1 in 5 users of the contraceptive implant have an increase in bleeding that persists beyond the first few months.

LARC use, and in particular the subdermal implant, is not known to be associated with pelvic inflammatory disease (PID) which is an infection of the upper part of the female reproductive system namely the uterus, fallopian tubes, and ovaries. PID is a known side effect of IUD insertion but occurs in less than 1 in 300 people. The risk of PID is only increased for the first 3 weeks after insertion, after which it returns to the previous background risk. Users of IUDs are encourage to return at any sign of infection and when treated promptly with antibiotics are unlikely to experience any long term complications.

New class of antibiotic raises hopes for urgently-needed gonorrhoea drug

The Guardian, Tuesday 8 August 2017 

A new class of antibiotic has been found to work in the lab against the sexually transmitted infection gonorrhoea, which can cause infertility and damage to babies and is fast becoming resistant to all existing drugs.

Although it is early days, because the antibiotic has yet to be tried in animals or humans, researchers say they are excited by its potential.