WHO releases new treatment guidelines for chlamydia,
gonorrhoea and syphilis in response to the growing
threat of antibiotic resistance.
Chlamydia, gonorrhoea and syphilis are all caused by
bacteria and are generally curable with antibiotics.
However, these STIs often go undiagnosed and are
becoming more difficult to treat, with some
antibiotics now failing as a result of misuse and
overuse. It is estimated that, each year, 131
million people are infected with chlamydia, 78
million with gonorrhoea, and 5.6 million with
Resistance of these STIs to the effect of
antibiotics has increased rapidly in recent years
and has reduced treatment options.
Of the 3 STIs, gonorrhoea has developed the
strongest resistance to antibiotics. Strains of
multidrug-resistant gonorrhoea that do not respond
to any available antibiotics have already been
Antibiotic resistance in chlamydia and syphilis,
though less common, also exists, making prevention
and prompt treatment critical.
When left undiagnosed and untreated, these STIs can
result in serious complications and long-term health
problems for women, such as pelvic inflammatory
disease, ectopic pregnancy, and miscarriage, and
untreated gonorrhoea and chlamydia can cause
infertility in both men and women.
Infection with chlamydia, gonorrhoea and syphilis
can also increase a personís risk of being infected
with HIV two- to three-fold. An untreated STI in a
pregnant woman increases the chances of stillbirth
and newborn death.
"Chlamydia, gonorrhoea and syphilis are major public
health problems worldwide, affecting millions of
peoples' quality of life, causing serious illness
and sometimes death.
The new WHO guidelines reinforce the need to treat
these STIs with the right antibiotic, at the right
dose, and the right time to reduce their spread and
improve sexual and reproductive health. To do that,
national health services need to monitor the
patterns of antibiotic resistance in these
infections within their countries," says Ian Askew,
Director of Reproductive Health and Research, WHO.
The new recommendations are based on the latest
available evidence on the most effective treatments
for these 3 sexually transmitted infections.
Gonorrhoea is a common STI that can cause infection
in the genitals, rectum, and throat. Antimicrobial
resistance has appeared and expanded with every
release of new classes of antibiotics for the
treatment of gonorrhoea. Because of widespread
resistance, older and cheaper antibiotics have lost
their effectiveness in treatment of the infection.
WHO urges countries to update their national
gonorrhoea treatment guidelines in response to the
growing threat of antibiotic resistance. National
health authorities should track the prevalence of
resistance to different antibiotics in the strains
of gonorrhoea circulating among their population.
The new guideline calls on health authorities to
advise doctors to prescribe whichever antibiotic
would be most effective, based on local resistance
The new WHO guidelines do not recommend quinolones
(a class of antibiotic) for the treatment of
gonorrhoea due to widespread high levels of
Syphilis is spread by contact with a sore on the
genitals, anus, rectum, lips or mouth, or from
mother to child during pregnancy. If a pregnant
woman has untreated syphilis and the infection is
transmitted to the fetus, this often causes it to
die. In 2012, mother-to-child transmission of
syphilis resulted in an estimated 143 000 early
fetal deaths or stillbirths, 62 000 neonatal deaths,
and 44 000 babies being born preterm or with
To cure syphilis, the new WHO guidelines strongly
recommend a single dose of benzathine penicillin Ė a
form of the antibiotic that is injected by a doctor
or nurse into the infected patientís buttock or
thigh muscle. This is the most effective treatment
for syphilis, as it is more effective and cheaper
than oral antibiotics.
Chlamydia is the most common bacterial STI and
people with this infection are frequently
co-infected with gonorrhoea.
Symptoms of chlamydia include discharge and a
burning feeling when urinating, but most people who
are infected have no symptoms. Even when chlamydia
is asymptomatic, it can damage the reproductive
WHO is calling on countries to start using the
updated guidelines immediately, as recommended in
the "Global Health Sector Strategy for Sexually
Transmitted Infections (2016-2021)" endorsed by
governments at the World Health Assembly in May
2016. The new guidelines are also in-line with the
"Global Action Plan on Antimicrobial Resistance",
adopted by governments at the World Health Assembly
in May 2015.
When used correctly and consistently, condoms are
one of the most effective methods of protection
For more information
WHO guidelines for the treatment of Neisseria
WHO guidelines for the treatment of Treponema
WHO guidelines for the treatment of Chlamydia