Whilst penicillin continues to offer an effective treatment for syphilis and azithromycin for chlamydia, finding an effective drug to treat gonorrhea and the less-known, but highly prevalent STI, Mycoplasma genitalium, poses a huge challenge.

Both infections have developed some resistance to all the antibiotics currently used to treat them, which is where diagnostics provide invaluable insight. The latest testing kits not only diagnose the condition: they can also detect specific drug resistance so the most effective antibiotic can be prescribed.

There needs to be shift in mentality from simply treating symptoms to managing the underlying conditions

- Dr Jorgen Skov Jensen

“The tests help us determine what drug the bacteria will be responsive to and in 40-60 per cent of patients we can effectively use a conventional cheap drug,” explains Dr Jorgen Skov Jensen, consultant physician in microbiology and infection control at Statens Serum Institut, Denmark.

The downside is that the tests are not currently available at the point of care, so patients have to return for their diagnosis and prescription. “There is a tradition that says unless you treat someone right then and there you risk losing contagious patients. But the experience in Scandinavia show that’s not the case,” explains Dr Jensen, who believes there needs to be shift in mentality from simply treating symptoms to managing the underlying conditions.

“In light of increased antimicrobial resistance, we need to move away from syndromic management to a situation where we diagnose the etiology of the condition before treating it with the correct antibiotics,” he explains. “Diagnostics can help us do that.”

 
Gonorrhoea case study (click to enlarge)
Infographic