Gonorrhea is becoming more resistant to drugs and ‘could become untreatable’

Health officials are warning that gonorrhoea is becoming increasingly resistant to antibiotics and could become untreatable in the future. A report has revealed that cases of gonorrhoea are on the rise in England.

Last year, 85,000 cases of gonorrhoea were diagnosed in England, the highest number since records began in 1918. If left untreated, the disease can lead to serious health problems, including pelvic inflammatory disease and infertility.

The vast majority of cases can be treated. But recently there has been an increase in people being diagnosed with strains that are resistant to ceftriaxone, the “first-line” antibiotic typically used to treat the infection.

Most of those affected were in their 20s, heterosexual and had contracted the infection abroad, although some had no travel history, the UK Health Security Agency (UKHSA) said. The public health agency confirmed that there had been transmission of ceftriaxone-resistant gonorrhoea in England.

The UKHSA is publishing a report on Thursday highlighting the worrying rise in antibiotic-resistant gonorrhoea infections in England and urging people to protect themselves by using condoms.

According to the UKHSA, 15 cases of ceftriaxone-resistant gonorrhoea were diagnosed in England between June 2022 and May 2024.

Five of them had super-strong strands, which health officials said led to “extremely drug-resistant” gonorrhea, meaning their infections were resistant to first- and second-line treatments and other antibiotics.

Because the infections were resistant to drugs, some of the 15 had to be hospitalized. They were given a cocktail of powerful drugs to prevent the gonorrhea from spreading to other parts of their bodies.

Before 2022, only nine cases of ceftriaxone-resistant gonorrhoea had been identified in England.

Dr Helen Fifer, a consultant microbiologist at the UKHSA, said: “Gonorrhoea is becoming increasingly resistant to antibiotics, raising the risk that it will become untreatable in the future. Untreated gonorrhoea can lead to serious health problems including pelvic inflammatory disease and infertility.

“Condoms are the best defense, but if you haven’t used one with a new or casual partner, get tested to detect the infection and prevent further transmission.”

For people who have sex without condoms with new or casual partners, regular testing for sexually transmitted infections such as gonorrhoea is “essential” to maintain good sexual health, the UKHSA said.

Testing is free and can be done at local sexual health clinics, university and college medical centers, or via self-collection kits sent in the mail.

Prof Matt Phillips, Chair of the British Association for Sexual Health and HIV (BASHH), said: “The increase in antibiotic-resistant gonorrhoea infections in England is a worrying trend that needs to be addressed with immediate action.

“Antibiotic resistance in STIs is an increasing threat to public health, potentially causing physical and psychological harm and placing additional demands on other parts of the NHS.”

BASHH, along with sector partners, had repeatedly called for a sexual health strategy for England, Phillips said. “This must be a priority if our expert sexual health workers are to effectively meet these growing and changing sexual health needs.”

The emergence of drug-resistant gonorrhoea comes amid growing concerns about rising rates of sexually transmitted infections (STIs) in England.

In 2023, 401,800 new cases of STIs were diagnosed, an increase of 4.7% since 2022. Chlamydia cases accounted for almost half of these, with 194,970 diagnoses in 2023.

In addition to 85,223 cases of gonorrhea, there were 9,513 cases of infectious syphilis – the highest number since 1948.

While the majority of syphilis cases were diagnosed in gay and bisexual men, the UKHSA said there was a larger “proportional increase” in syphilis diagnoses in heterosexual men and women.