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Gepotidacin, an antibiotic currently used to treat urinary tract infections, could be a new treatment to treat gonorrhea, protecting against the threat of treatment-resistant gonorrhea and improving patient treatment experiences, suggests the results of a phase 3 randomized control trial published in The Lancet and presented at the ESCMID conference.
Gonorrhea is a common sexually transmitted infection that—if not treated promptly—can result in serious complications, especially for women, in whom it can lead to increased risks of ectopic pregnancy and infertility. Cases of drug-resistant gonorrhea have increased rapidly in recent years, reducing the options for treatment. There is an urgent need for new treatments for gonorrhea with no new antibiotics since the 1990s.
This trial of 622 patients compared a potential new treatment for uncomplicated gonorrhea (gepotidacin, an oral pill) with the current standard treatment (ceftriaxone, an injection; and azithromycin, a pill) and found the new pill to be as effective as the current standard treatment at treating the infection.
Crucially, the new pill was effective against strains of the gonorrhea bacteria that are resistant to existing antibiotics. There were no treatment-related severe or serious side effects for those treated with either medication.
Authors say the new treatment could be an important tool in combating the rise of gonorrhea strains that are becoming resistant to the standard treatment. Additionally, treatment as a pill alone without the need for an injection would likely improve patient experiences and reduce health care resources.
However, the authors also caution that this study looked primarily at urogenital gonorrhea and that most of the study group were white men. Therefore, more research is needed to see the impact of the new treatment on gonorrhea of the rectum and throat, and in women, adolescents, and diverse ethnicities.
More information:
Jonathan D C Ross et al, Oral gepotidacin for the treatment of uncomplicated urogenital gonorrhoea (EAGLE-1): a phase 3 randomised, open-label, non-inferiority, multicentre study, The Lancet (2025). DOI: 10.1016/S0140-6736(25)00628-2
Citation:
Antibiotic-resistant gonorrhea may meet its match with new pill (2025, April 14)
retrieved 15 April 2025
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