Redacción Farmacosalud.com
Según el estudio ‘Zoliflodacin versus ceftriaxone plus azithromycin for treatment of uncomplicated urogenital gonorrhoea: an international, randomised, controlled, open-label, phase 3, non-inferiority clinical trial’, publicado en ‘The Lancet’the oral antibiotic zoliflodacin is non-inferior to ceftriaxone + azithromycin for the treatment of uncomplicated urogenital gonorrhea and has a similar safety profile. “The antibiotic zoliflodacin, which is administered as a single pill in a single dose, cures more than 95% of infections when it comes to uncomplicated urogenital gonorrhea,” says Dr. Santiago Moreno, head of the Infectious Diseases Service at the Ramón y Cajal University Hospital (Madrid).
Now, “its effectiveness is not known in complicated gonorrhea or in extragenital locations,” the expert points out next.
Autor/a: SergioYoneda
Fuente: depositphotos.com
“In Spain, resistance to ceftriaxone is practically non-existent”
Zoliflodacin, therefore, is postulated as a new therapeutic resource for this sexually transmitted disease (STI), given the growing resistance of the bacteria. Neisseria gonorrhoeae or gonococcus – which causes gonorrhea – versus antimicrobials such as ceftriaxone. “Zoliflodacin is active against sensitive gonococcus and gonococcus resistant to ceftriaxone. It is useful, therefore, in both scenarios, but in Spain resistance to ceftriaxone is practically non-existent. Ceftriaxone is, therefore, still the antibiotic of choice against gonorrhea,” explains Dr. Moreno.
For all these reasons, the doctor considers that it is currently not necessary for zoliflodacin to be urgently incorporated into the National Health System (SNS), even though there is a growing increase in STIs in Spanish territory: “no, its incorporation is not urgent at this time. It is a useful antibiotic especially in cases of gonorrhea resistant to ceftriaxone”, and, given that for now in Spain the gonococcus is not persistent against ceftriaxone, the use of zoliflodacin would not be recommended.
“For cases sensitive to ceftriaxone, this antimicrobial -ceftriaxone- is very effective, well tolerated and economical. Improper use of zoliflodacin could lead to the emergence of resistance and we would lose a tremendously precious antibiotic for situations in which there are no alternatives,” he warns.
Dr. Santiago Moreno
Author of the image: Enric Arandes
Source: E. Arandes / www.farmacosalud.com (FILE IMAGE)
With zoliflodacin, “complete elimination of the infection may take a few days”
“The misuse of antibiotics is behind the appearance of resistance in any bacteria. Also in the case of gonococcus, although in this scenario not necessarily due to the inappropriate use of ceftriaxone to treat it,” says Moreno.
The effect of zoliflodacin begins to be noticed as soon as it reaches sufficient concentrations at the site of the infection, such that “the complete elimination of said infection may require a few days,” says the head of the Infectious Diseases Service at the Ramón y Cajal University Hospital.
Alert to the increase in late HIV diagnoses
On the other hand, the Spanish Society of Primary Care Physicians (SEMERGEN), through its Sexology Working Group, warns that the fight against HIV infection (the virus that causes AIDS) continues to be a major public health challenge, despite the scientific and social advances of recent decades. The clinical transformation of the infection – today controllable thanks to antiretroviral treatment – coexists with a growing sense of false security. Proof of this are the almost 3,000 new HIV diagnoses annually in Spain, many of them late, when the virus has already compromised the immune system. It should be remembered that one of the ways of transmitting this pathogen is through sexual contact.
The word AIDS corresponds to the initials of Acquired Immune Deficiency Syndrome. This pathology is an advanced state of the infection caused by the Human Immunodeficiency Virus (HIV) that causes the progressive destruction of the immune system, reports the Ministry of Health. Four fluids, blood, semen, vaginal secretions and breast milk of infected people, have a sufficient concentration of this virus to transmit it. This means that HIV can be transmitted through three routes: sexual, blood and from mother to child. Furthermore, for infection to occur, HIV must penetrate the body and come into contact with the blood or mucous membranes (lining of the inside of the mouth, vagina, penis and rectum).
Source: SEMERGEN
Regarding the sexual route of transmission, this can take place in a context of intimate relations with penetration (anal, vaginal or oral) without a condom. Anal penetration is the highest risk practice, followed by vaginal penetration. Oral sex has much lower risk, especially without ejaculation, the same sources indicate.
SEMERGEN highlights the need to strengthen healthcare systems to reinforce prevention and early diagnosis and move towards disease control. According to Dr. María Zamora, member of the SEMERGEN Sexology Working Group, “HIV prevention requires a comprehensive approach that combines rigorous sexual education, equitable access to preventive tools such as PrEP* and PEP**, consistent condom use, periodic screening for sexually transmitted infections, and a firm social and health commitment to eliminating the stigma that still surrounds this infection.”
*PrEP: pre-exposure prophylaxis
**PEP: post-exposure prophylaxis
