Use a condom: gonorrhoea on the rise in Australia

Western Sydney Sexual Health Centre director Professor David Lewis.

Western Sydney is on the front line of the fight against drug-resistant sexually transmitted infections that could be devastating to global health.

Condom use and regular sexual health check-ups are being urged by Western Sydney Sexual Health Centre director Professor David Lewis in the wake of a 115% rise in gonorrhoea infections in major Australian cities in recent years.

Prof Lewis spoke about the implications of antimicrobial resistance (AMR) for sexual health during day one of Hospital Week at Westmead Hospital today.

“We are now on our last major first line class of drugs to treat gonorrhoea,” Prof Lewis said.

“Many regions of Australia are also witnessing rising resistance to the second drug we rely on to treat gonorrhoea as part of dual drug therapy, and there’s no obvious alternative available right now.”

Gonorrhoea is a common infection that can be spread by vaginal, anal and oral sex. In men it can cause symptoms including discharge and a burning sensation when urinating, but anal and throat infections are usually silent.

Most women do not have any symptoms, and if left untreated it can lead to serious and permanent reproductive health problems including ectopic pregnancies, infertility and long-term pelvic pain.

Two alternative drugs are about to enter their third phase of testing, which is the final phase before a drug receives approval for use in the general public. Western Sydney Sexual Health Centre is an approved site for one of those trials.

The Centre is also one of 21 different organisations developing an integrated diagnostic and pharmaceutical approach to antibiotic resistance as part of the newly-funded Australian Research Council (ARC) Research Hub to Combat Antimicrobial Resistance.

Prof Lewis said improved diagnostic testing is letting doctors know which antibiotic to prescribe, and Australia is benefiting from the world’s best AMR surveillance system.

“Geographically we are on the front wave of antibiotic resistance developing in the Asia-Pacific region. In April last year, the Australian Government notified the World Health Organisation of two cases of extensively drug-resistant gonorrhoea, so it is concerning,” he said.

“We are also a long way from a vaccine. The bacterium that causes gonorrhoea is an extremely clever organism; it’s like a chameleon constantly changing how it appears so the immune system doesn’t recognise it.”

Prof Lewis said condom use and regular (at least annual) sexual health checks were the most important safeguards for any sexually active people.

“The bacteria can live quite happily in the urethra, the anus and the throat without any symptoms, so you should be safe and get tested just to be sure,” he said.