Sexually transmitted infection may be cured with this
"This is just one case, and the findings should be taken in that context."
A treatment-resistant sex bug may be cured by an antibiotic tablet used to treat eye infections.
Doctors say it could prove an effective medicine for a sexually transmitted infection (STI) that has become resistant to usually recommended treatments after they successfully treated a young man in London.
He was given the antibiotic chloramphenicol - usually prescribed to treat conjunctivitis - after he was found to have Mycoplasma genitalium (non-gonococcal) urethritis following unprotected sex with a casual partner.
Data from the UK Health Security Agency suggest rising antimicrobial resistance to first and second-choice drugs used to treat the infection, while there’s currently no strong evidence for third choice options.
Doctors described in the journal Sexually Transmitted Infections the case of a young man with recurrent non-gonococcal urethritis symptoms, a common STI caused by Mycoplasma genitalium that has become increasingly difficult to treat with currently recommended antibiotics.
Study author Dr. Mike Rayment said: "The young man initially turned up at the clinic with two-day old symptoms, a fortnight after having unprotected sex with a casual partner.
"He was initially treated with a week’s course of doxycycline, pending test results to identify the exact bacterial cause of his infection.
"The results showed that he was infected with M genitalium and he was then prescribed another antibiotic, azithromycin.
"Once the lab analysis revealed that it was a treatment resistant strain, he was then given a third antibiotic, moxifloxacin.
"But five days after completing all the courses of antibiotics, he still had symptoms."
After considering other options, which were dismissed due to cost, availability, or licensing issues, the docotrs decided to try chloramphenicol: one gram tablet taken four times a day for 14 days.
Rayment, of the Directorate of HIV and Sexual Health at Chelsea and Westminster Hospital NHS Foundation Trust, said the decision was prompted by test tube evidence showing that chloramphenicol stopped M genitalium in its tracks and the ready availability of the drug.
He said: "After 14 days of treatment, the young man’s symptoms had cleared up and lab tests confirmed that he no longer had urethritis.
"This is just one case, and the findings should be taken in that context.
“When considering what to choose after first- and second-line treatment failure, there is a lack of novel agents readily available in the UK, and a paucity of data to underpin recommendations.”
Rayment said chloramphenicol is generally well tolerated, with the serious side effects rare.
He says that, in the absence of viable, effective alternatives, it merits further investigation.
Rayment added: “Options for third-line therapies in treatment-resistant M genitalium are urgently required.
"Chloramphenicol may have an application in this scenario, and should be considered as a possible drug for investigation."
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