Gonorrhea treatment has involved a number of different drugs over the years. In the early years of gonorrhea therapy (1930s and 1940s), sulfonamide antimicrobials and penicillin were used effectively to treat cases of gonorrhea. However, through mutations, the disease became resistant to these forms of treatment over time, requiring larger doses to ensure the success of the treatment (CDC, 2013).
This is again happening as over the past decade or so the number of advised treatment options have been decreased due to drug resistance. As of 2006, the only remaining antimicrobials recommended for treatment of the disease in the United States are cephalosporins such as cefixime and ceftriaxone. In 2010, the CDC changed their recommendations to advise combination drug therapy featuring increased dosage of cephalosporin as well as a second antimicrobial. Gonococcal Isolate Surveillance System (GISP) now has growing evidence that cephalosporin resistance may be increasing in the U.S. This was first witnessed in the early 2000's in East Asia, and has since been observed in Europe and now the U.S. Due to these factors, new antimicrobial treatment options are needed. Despite the growing need for new treatment options, only one new antimicrobial is currently undergoing clinical study as a possible treatment. As the development process of new drugs can be a lengthy endeavor, the time for research and improvement is now (CDC, 2013). The figure on the right shows the percentage of instances in which samples of urethral isolates from those infected displayed resistance to the drugs cefixime and ceftriaxone.