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A major breakthrough in the fight against drug-resistant infections has been announced. Researchers have developed a new oral antibiotic, gepotidacin, to treat gonorrhoea — the first new treatment for this sexually transmitted infection in over 30 years.

First Pill-Based Gonorrhoea Treatment in Decades

The new drug offers an alternative to the current standard therapy, which involves an injection of ceftriaxone combined with an oral dose of azithromycin. Unlike these treatments, gepotidacin is taken as a pill. Scientists say this makes the process more comfortable for patients and easier to deliver, especially in busy healthcare systems.

In a recent phase-three clinical trial, gepotidacin was tested on 622 people across six countries: the United Kingdom, United States, Australia, Germany, Mexico, and Spain. The results were presented at the ESCMID conference in Vienna and published in The Lancet. The new drug performed just as well as the current method and, importantly, also worked against drug-resistant strains of gonorrhoea.

No serious side effects were reported from either treatment, giving doctors hope that gepotidacin can be a safe alternative when older antibiotics stop working.

Rising Drug Resistance Makes New Options Urgent

Gonorrhoea is a common infection, but if left untreated, it can cause serious health issues. In women, it may lead to infertility or increase the risk of dangerous ectopic pregnancies. The disease also affects men and can spread silently through communities.

In recent years, drug-resistant gonorrhoea has become a global concern. In England alone, 2023 saw over 85,000 reported cases—the highest number since records began in 1918. Many cases involved people in their twenties, some of whom had recently traveled, but others had not. This trend shows that the infection is spreading locally and that current treatments may no longer be enough.

UK health officials have issued warnings about strains that resist multiple antibiotics. Until now, there were no new antibiotics for gonorrhoea since the 1990s. Gepotidacin may finally offer a new tool in doctors’ arsenals.

How Gepotidacin Works

Gepotidacin works differently from older antibiotics. It targets bacteria in a unique way, helping to avoid existing resistance mechanisms. The clinical trial showed that gepotidacin achieved “non-inferiority,” meaning it was just as effective as the current treatment combo in clearing infections.

Experts believe this makes gepotidacin a potential game-changer. The drug could serve as a backup when current treatments fail and may help delay the spread of resistant strains.

Dr. Stephanie Taylor, one of the study’s lead researchers, said, “We finally have an oral treatment that works against gonorrhoea, including the resistant types. This is a critical step forward.”

Still More Questions to Answer

While the results are promising, the study focused only on uncomplicated urogenital gonorrhoea. Most participants were white men, and the drug’s effect on throat or rectal infections is still unclear. Experts say more trials are needed in different populations and infection sites to fully understand the drug’s impact.

Despite these limitations, the trial marks a significant advance in infectious disease research.

Antibiotic resistance is one of the world’s biggest health threats, causing an estimated 3,500 deaths every day. In 2019, more than 1.2 million people died due to infections that did not respond to existing drugs. Experts warn that without action, routine infections could become untreatable in the near future.

What This Means for Public Health

The new treatment gives hope that gonorrhoea — once feared to become untreatable — may have a new line of defense. The ease of oral delivery could make the drug ideal for use in clinics, emergency rooms, or even remote areas.

If approved, gepotidacin could reshape how doctors treat gonorrhoea, especially in cases where patients are allergic to standard antibiotics or when strains become resistant to all other options.

For now, health experts are cautiously optimistic. The next steps include wider trials, regulatory review, and production planning.