Health leaders have sounded the alarm over a rise in cases of drug-resistant gonorrhoea. Cases of the sexually transmitted infection (STI) have soared and are now at their highest level since records began in 1918.
The latest figures for England show there were 85,223 cases of gonorrhoea diagnosed in 2023. As well as a rise in cases of the STI, health officials have also found an increase in treatment-resistant gonorrhoea.
While the infection is usually easy to treat, some strains are resistant to commonly used antibiotics and are harder to treat. The first-line treatment in England is an antibiotic called ceftriaxone, the UK Health Security Agency (UKHSA) said.
New data from the UKHSA, published on medRxiv, highlights the growing number of drug-resistant cases in recent years. Only nine ceftriaxone-resistant gonorrhoea infections were reported in England between 2015 up to the end of 2021.
This rose to 15 cases detected in England between June 2022 and May 2024, including five cases that were “extensively drug-resistant” meaning they did not respond to both first and second-line treatment options and to other antibiotics. All the drug-resistant detected cases have been among heterosexual people, mostly in their 20s, according to the paper.
Most of them had acquired the infection abroad. Dr Helen Fifer, consultant microbiologist at UKHSA, said: “Gonorrhoea is becoming increasingly resistant to antibiotics, risking the possibility of it becoming untreatable in the future. Untreated gonorrhoea can lead to serious health issues, including pelvic inflammatory disease and infertility.”
“Condoms are the best defence, but if you didn’t use one with a recent new or casual partner, get tested to detect the infection and prevent onwards transmission.”
Professor Matt Phillips, president of the British Association for Sexual Health and HIV (BASHH), added: “The rise of antibiotic-resistant gonorrhoea infections in England is a worrying trend that must be addressed with immediate action. Antibiotic resistance of STIs poses an increasingly major public health threat, which can create physical and psychological harms and place additional demands on other parts of the NHS.
“BASHH, alongside sector partners, has repeatedly called for a sexual health strategy for England; this must be a priority if our expert sexual health workforce are to effectively meet these growing and changing needs in sexual health.”
