Translating mouthwash use for gonorrhoea prevention into a public health campaign: identifying current knowledge and research gaps
Eric P. F. Chow A B C , Kate Maddaford A , Sabrina Trumpour A B and Christopher K. Fairley A BA Melbourne Sexual Health Centre, Alfred Health, 580 Swanston Street, Carlton, Vic. 3053, Australia.
B Central Clinical School, Monash University, 99 Commercial Road, Melbourne, Vic. 3004, Australia.
C Corresponding author. Email: eric.chow@monash.edu
Sexual Health 16(5) 433-441 https://doi.org/10.1071/SH18237
Submitted: 20 December 2018 Accepted: 13 February 2019 Published: 17 May 2019
Journal Compilation © CSIRO 2019 Open Access CC BY-NC-ND
Abstract
The gonorrhoea rate among gay and bisexual men who have sex with men (MSM) has been increasing rapidly in many Western countries. Furthermore, gonorrhoea is becoming increasingly resistant to antibiotics and only limited options remain for treatment. Recent evidence suggests that the oropharynx may play an important role in gonorrhoea transmission. It is hypothesised that reducing the prevalence of oropharyngeal gonorrhoea will also reduce the population incidence of gonorrhoea. Mouthwash has been proposed as a novel non-antibiotic intervention to prevent oropharyngeal gonorrhoea; hence, reducing the probability of antibiotic resistance developing. However, its efficacy is yet to be confirmed by a randomised controlled trial – the findings of which will be available in 2019. If the trial shows mouthwash is effective in preventing gonorrhoea, this finding could potentially be translated into a public health campaign to increase the mouthwash use in the MSM population. This article summarises the current evidence of the effectiveness of mouthwash against gonorrhoea and discusses the potential literature gaps before implementing the mouthwash intervention at a population level.
Additional keywords: gay men, intervention, men who have sex with men, Neisseria gonorrhoeae, prevention, sexually transmitted diseases, sexually transmissible infections.
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