Why is antibiotic resistance in gonorrhea such a concern?
Neisseria gonorrhoeae — the bacterium that causes gonorrhea — has shown a remarkable ability to develop resistance to antibiotics over decades. It has successively evolved resistance to penicillin, tetracyclines, fluoroquinolones, and earlier cephalosporins. We are now at a point where the treatment options are limited, and cases of extensively drug-resistant (XDR) gonorrhea that are very difficult to treat have been identified globally.
What is the current recommended treatment?
In the US, the CDC recommends a single intramuscular injection of ceftriaxone as first-line treatment for uncomplicated gonorrhea. Dosing may be higher for pharyngeal (throat) infections, which are harder to treat. Oral antibiotics alone are no longer recommended as first-line treatment due to rising resistance. Always follow current CDC STI treatment guidelines and your clinician's advice.
What should you do if you are diagnosed with gonorrhea?
You should attend a health department STD clinic or see a clinician to receive treatment rather than relying on over-the-counter or online antibiotics. Clinics can culture a sample to check which antibiotics your infection responds to, administer the injection, and advise on partner notification. A test of cure — retesting 2 weeks after treatment — is often recommended to confirm that the infection has cleared, especially for throat infections.
How does gonorrhea develop resistance?
Resistance develops when bacteria are exposed to an antibiotic but are not completely killed — surviving bacteria can pass on genetic mutations that confer resistance. This is accelerated by incomplete courses of treatment, using the wrong antibiotic, or self-treating with antibiotics obtained without a prescription. Global travel also spreads resistant strains rapidly across countries.