Modern problems of treatment of genital infections according to WHO estimates

Hundreds of millions of new cases of curable sexually transmitted infections (STIs) are registered worldwide each year. The clinical management and control of these sexually transmitted infections must include quality access to services that provide timely and accurate diagnosis of diseases along with effective treatment. Ensuring adequate treatment is complicated by increasing antimicrobial resistance, in particular in gonorrhea and mycoplasma infections, which require new treatments and management algorithms. In addition, infections such as chlamydia, syphilis and trichomoniasis are common and require more effective public health controls.

Actual problems of treatment of sexual infections

In 2008, the World Health Organization (WHO) estimated that there were 499 million new cases of curable sexually transmitted infections worldwide, including gonorrhea, mycoplasma, chlamydia, and syphilis. This figure was even higher than the 448 million cases reported in 2005. In this article, estet-portal.com focuses on the challenges doctors face in the clinical management of several key treatable STDs and how to address these challenges.

The main problems in the treatment of sexually transmitted infections are the resistance of pathogens to antimicrobial drugs, as well as the high prevalence of certain sexually transmitted infections.

Sexual infections:

• what are the current problems in the treatment of sexually transmitted infections;
• Methods for solving actual problems in the treatment of sexual infections.

What are the current problems in the treatment of sexually transmitted infections

Actual problems of treatment of sexually transmitted infections are individual for each disease. Of course, modern medicine is making every effort to solve these problems. With regard to some sexually transmitted infections, practitioners should be aware of the possibility of such problems:

• Gonococcal Infection: Over several decades, gonococci have consistently developed antimicrobial resistance to several classes of antibiotics, which has been identified by the US Centers for Disease Control as one of the leading threats.  Reports of high-level resistance to ceftriaxone – these are alarm signals and additional incentives for the discovery of new alternative therapies;
• Mycoplasma infection  is a common cause of male urethritis and is associated with pelvic inflammatory disease in women. Like gonococci, genital mycoplasmas have developed increased resistance to various classes of antibiotics. This problem is currently recognized as one of the most dangerous. To solve it, it is necessary to test the resistance of mycoplasmas to antimicrobial drugs, as well as to ensure constant monitoring of the patient until his full recovery;
• chlamydia: For chlamydia, there is still uncertainty about which single dose of azithromycin should be used as the basis for treating uncomplicated genital chlamydial infection, or whether doxycycline should be preferred for treating chlamydia. Whether doxycycline should replace single-dose azithromycin as first-line therapy for chlamydial infection requires further study;
• Syphilis: Globally, syphilis remains an ongoing problem with international data pointing to a surge in syphilis among men who have sex with men, as well as unacceptably high rates of congenital syphilis. In 2008, WHO estimated that contracting syphilis during pregnancy led to the birth of  305,000 dead fetuses and 215,000 babies at risk of death from prematurity, low birth weight, or congenital syphilis.

 

Methods for solving actual problems of treatment of genital infections

The WHO Global Strategy for the Prevention and Control of Sexually Infections stipulates that the integrated management of these diseases should include, as a minimum, accurate and timely diagnosis, as well as effective treatment to prevent complications and further transmission of these diseases.

While laboratory testing is widely used in high-income countries, it is still beyond the reach of many low- and middle-income countries. Similarly, there are concerns regarding the availability of essential antibacterial drugs for the treatment of genital infections. To solve the problems associated with the high prevalence and ineffective treatment of sexually transmitted infections, it is necessary, first of all, to take care of these issues.