According to the World Health Organization (WHO), a drug-resistant form of gonorrhea is circulating around the world putting many people at risk of contracting untreatable gonorrhea.  Multiple countries have already reported cases of resistance to cephalosporin antibiotics–the last treatment option against gonorrhea. Antimicrobial resistance is caused by the unrestricted access to antimicrobials, overuse and poor quality of antibiotics, as well as natural genetic mutations within disease organisms. In addition, gonorrhea strains tend to retain genetic resistance to previous antibiotics even after their use has been discontinued. Gonorrhea is the second most commonly reported bacterial sexually transmitted infection (STI).

WHO’s Global Action Plan to control the spread and impact of antimicrobial resistance in Neisseria gonorrhoeae calls for increased monitoring and reporting of resistant strains as well as better prevention, diagnosis and control of gonococcal infections.

The United States Preventive Services Task Force recommends that clinicians provide screening for only those at increased risk for infection:

  • Pregnant
  • Previous gonorrhea infection or other STIs
  • New or multiple sex partners
  • Inconsistent condom use
  • Commercial sex work and drug use
  • Women in certain demographic groups
  • Living in a community with high disease prevalence

Anyone found to have gonorrhea also should be tested for other STIs, including chlamydia, syphilis, and HIV.

Since antibiotics were first used for treatment of gonorrhea, N. gonorrhoeae has progressively developed resistance to the antibiotic drugs prescribed to treat it: sulfonamides, penicillin, tetracycline, and ciprofloxacin. Currently, CDC treatment guidelines recommend dual therapy with an injectable cephalosporin, ceftriaxone, and either azithromycin or doxycycline to treat all uncomplicated gonococcal infections among adults and adolescents in the United States. Also, there is ongoing research and investigation for the development of new treatments.

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