Sex disease on increase as standard drug loses its power

By MARTIN JOHNSTON

Doctors are worried by the growing resistance of many cases of the sexually transmitted disease gonorrhoea to Auckland's standard treatment.

This follows a rapid increase in the number of gonorrhoea cases.

Health Ministry figures show there were 150 confirmed cases in the March quarter - twice the figure for one quarter in 1996.

But the real number is thought to be far higher, because the figures do not include cases from GPs or family planning clinics.

Resistance to ciprofloxacin, an antibiotic pill, was low in the 1990s in Auckland, but rose to 2.3 per cent of cases last year, 5.1 per cent of cases in the first quarter of this year and 11.2 per cent in the second. Resistant cases have also been found in Hamilton and Palmerston North.

Sydney and parts of Asia have much higher rates of resistance to the drug than Auckland.

Dr Janet Say, a specialist at the Auckland Sexual Health Service, said yesterday that gonorrhoea cases in the region were generally resistant to penicillin, so ciprofloxacin was the standard treatment.

The only alternative in New Zealand, ceftriaxone, which requires an injection, is not suitable for all patients, and is funded by the Government for gonorrhoea in hospitals, but not for GPs or family planning clinics, where many people are treated.

Dr Say said that if the rising resistance to ciprofloxacin continued, other drugs would have to be considered.

Dr Peter Moodie, medical director of Pharmac, the Government's drug-subsidising agency, said that no application had been made to subsidise ceftriaxone for gonorrhoea treatment.

If one was made, it would be considered. But more pressing than the funding issue was a concern that widening access to ceftriaxone could worsen the problem of antibiotic resistance.

Pharmac would have to seek expert advice on that.

Health Ministry spokesman Bob Boyd said the ministry would support a bid to have Pharmac pay for the drug if the trend of resistance to ciprofloxacin continued and if venereologists made a case for the wider availability of ceftriaxone.