If you thought oral sex was a safer option to vaginal or anal, think again. The World Health Organisation released a warning citing the rise of drug-resistant strains of gonorrhoea that are spreading through unsafe oral sex.
According to the 7 July press release, data accumulated from 77 countries show that "antibiotic resistance is making gonorrhoea – a common sexually-transmitted infection – much harder, and sometimes impossible, to treat". With few drugs already available to counter the bacteria and even fewer that are having any effect on the new strains, experts claim the situation is "fairly grim".
"The bacteria that cause gonorrhoea are particularly smart. Every time we use a new class of antibiotics to treat the infection, the bacteria evolve to resist them," said Dr Teodora Wi, Medical Officer, Human Reproduction, at WHO.
Each year, approximately 78 million people are infected with gonorrhoea, with decrease in condom use being a major reason for its spread. The bacteria infect the genitals, rectum, and throat and can particularly affect women's fertility. It also increases the risk of HIV.
"When you use antibiotics to treat infections like a normal sore throat, this mixes with the Neisseria species in your throat and this results in resistance," Dr Wi explained. "In the US, resistance [to an antibiotic] came from men having sex with men because of pharyngeal infection."
According to surveys conducted in the US and UK, more people participate in oral sex and while doctors recommend using a condom for it, the practice is extremely unpopular. Dr Mark Lawton from the British Association for Sexual Health and HIV told BBC that people with throat gonorrhoea are less likely to recognise the symptoms and therefore more likely to spread it unknowingly.
"My message would be to get tested so at least if you've got it you know about it," Dr Lawton said.
What makes the situation even dire is the fact that only three new candidate drugs are in various stages of clinical development. Additionally, pharmaceutical companies are not eager to develop new antibiotics for gonorrhoea from a commercial standpoint. The drugs are taken for a short duration and the bacteria also develop resistance to them quickly.
Dr Manica Balasegaram, director of Global Antibiotic Research and Development Partnership, stressed the need for more research and development. "To address the pressing need for new treatments for gonorrhoea, we urgently need to seize the opportunities we have with existing drugs and candidates in the pipeline," She said.
"In the short term, we aim to accelerate the development and introduction of at least one of these pipeline drugs, and will evaluate the possible development of combination treatments for public health use.
"Any new treatment developed should be accessible to everyone who needs it, while ensuring it's used appropriately, so that drug resistance is slowed as much as possible."