As if news that syphilis rates are rising among gay and bisexual men around the nation weren't sobering enough, now researchers from San Francisco are reporting that drug-resistant strains of the sexually transmitted disease have been confirmed in some gay men. Health officials in the city have documented eight cases of syphilis in gay men that are resistant to azithromycin, one of three drugs commonly used to treat the disease. All of the men were later successfully treated with either doxycycline or penicillin, according to Samuel Mitchell, an epidemiologist with the Centers for Disease Control and Prevention and one of the study authors. San Francisco's City Clinic has dropped azithromycin for treating most cases of primary and secondary syphilis in light of the study's findings. Researchers also are examining whether HIV coinfection has anything to do with the drug-resistant strains of syphilis as five of the eight men carrying the azithromycin-resistant strain were also HIV-positive.
"The downside of azithromycin becoming less useful is that it will probably limit our ability to do in-the-field prophylactic treatment," said Mitchell, noting that the drug is taken orally and penicillin used to treat the disease is injected. Health officials also worry that gay men with syphilis who are treated with azithromycin and do not respond to the drug could put others at risk for infection if they mistakenly believe they've been cured of the STD and resume having unprotected sex.