Optional Treatments for 3 Hard-to-Cure Conditions

With drug options dwindling due to increased antibiotic resistance, doctors are having to develop new strategies to combat common maladies. Here are ways to beat (or avoid) Salmonella poisoning, gonorrhea, and acne, which are getting harder to treat.

Salmonella poisoning
In 2006, an outbreak of food poisoning associated with ground beef affected an estimated 2,200 people in the Northeast. It was caused by a highly drug-resistant form of Salmonella typhimurium DT104 that doesnt respond to five commonly used antibiotics.

“Its worrisome because it means were losing oral antibiotics as an option for treating salmonella,“ says Paul Auwaerter, MD, clinical director of the division of infectious diseases at Johns Hopkins University School of Medicine in Baltimore. “Were using up the antibiotics that work and dont have new ones in the pipeline.”

Your best defense: Practice good kitchen hygiene. And keep raw meat, poultry, and seafood separate from other foods in your grocery cart and fridge, and during food prep.

Next Page: Gonorrhea and Acne [ pagebreak ]Gonorrhea
In 2007 the Centers for Disease Control and Prevention (CDC) recommended that doctors no longer use fluoroquinolones, a class of antibiotics that had been the first-line treatment for the 700,000 or so people who contract gonorrhea in the United States each year. The reason: This sexually transmitted infection was rapidly developing resistance to the drugs. Because the bug has already become resistant to penicillin, tetracyclines, and sulfanilamides, that leaves doctors with just one class of drugs—cephalosporins.

“Its very concerning, because in women untreated gonorrhea can lead to pelvic inflammatory disease, an illness that can cause chronic pelvic pain and infertility,” says Pennan Barry, MD, an infectious-disease fellow at the University of California, San Francisco. “Weve seen spots of resistance to the cephalosporins in Asia and Australia, so were monitoring it very closely in the United States.”

Your best defense: If youre not in a monogamous relationship with a partner whos been tested and is uninfected, use a condom every time you have sex. (A woman has an 80 to 90% chance of contracting the bug from just one episode of unprotected sex with an infected man.) And get screened if you have any symptoms: pain or burning during urination, increased vaginal discharge, or bleeding between periods. About half of women who contract gonorrhea dont have any symptoms, however, so an annual screening is critical.

There was a time when doctors prescribed antibiotics for inflammatory acne without a qualm. “We do that less now because it may stimulate resistance. And it may not work as well because Propionibacterium acnes has developed resistance to some of the antibiotics we commonly use, like erythromycin and tetracycline,” says Diane Berson, MD, an assistant clinical professor of dermatology at Weill Medical College of Cornell University in New York City.

Your best defense: Use a three-pronged approach: topical retinoid to unclog pores, a low-dose antibiotic, and a combo topical antibiotic-and-benzoyl-peroxide gel.

“The low-dose antibiotics treat the inflammation, and the benzoyl peroxide helps prevent resistance because it kills all the bacteria, including the ones that are resistant to the drugs,” Dr. Berson says. Another option: birth control pills. “Sometimes acne doesnt respond to antibiotics because its driven by hormones. If thats the case, a low-dose Pill can help,” she says.

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