Gonorrhoea risks becoming ‘untreatable’ amid rising antibiotic-resistant cases

Cases of gonorrhoea infections that are resistant to antibiotics are on the rise in England, officials have warned.

If not tackled, increased resistance could one day make the sexually transmitted infection (STI) “untreatable”.

Gonorrhoea can usually be treated effectively, although some cases can be resistant to the antibiotic ceftriaxone, which is the first line of treatment.

This means the bacteria that causes the infection has developed the ability to survive and multiply even when exposed to the antibiotic.

Some cases are also classed as “extensively drug resistant” – or XDR – meaning the infection did not respond to ceftriaxone or the second line of treatment.

New figures from the UK Health Security Agency (UKHSA) show that in the 15 months from January 2024 to March 2025, there were 17 cases of ceftriaxone-resistant gonorrhoea.

Thirteen were reported in 2024, with four cases in 2025 so far.

This is compared to 16 cases across 2022 and 2023.

In the same period, there were nine XDR cases reported – six in 2024 and three in 2025 so far.

This is compared to five cases between 2022 and 2023.

Ceftriaxone-resistant gonorrhoea was first detected in England in 2015 and 42 cases have since been reported.

Most cases are linked to the Asia-Pacific region, were resistance to ceftriaxone is common, according to the UKHSA.

Transmission in England is so far limited, but rising cases could present treatment challenges in the future.

Symptoms of gonorrhoea include green or yellow discharge from the vagina or penis, pain when urinating, pain and discomfort in the rectum.

For women, symptoms can include lower abdominal pain or bleeding between periods.

However, many people do not have symptoms.

Dr Katy Sinka, consultant epidemiologist and head of the STI section at UKHSA, said: “Gonorrhoea is becoming increasingly resistant to antibiotics, which could make it untreatable in future.

“If left untreated, it can cause serious problems like pelvic inflammatory disease and infertility.”

Neisseria gonorrhoeae, the bacteria that causes gonorrhoea, appears on the UKHSA’s list of viruses and bacteria which pose the greatest threat to public health.

Figures from the agency show there were about 54,965 gonorrhoea diagnoses at sexual health services in the first nine months of 2024 compared to more than 85,000 in the whole of 2023.

There were also about 7,000 syphilis cases in the first nine months of last year compared to 9,513 in the whole of 2023.

Dr Sinka added: “The best way to stop STIs is by using a condom.

“If you’ve had condomless sex with a new or casual partner, get tested, whatever your age, gender or sexual orientation. This includes when you are having sex abroad.

“Early detection not only protects your health but prevents transmission to others. Many STIs show no symptoms, which is why regular testing is so important.

“Testing is quick, free and confidential.”