Health officials in England are raising concerns about a surge in antibiotic-resistant gonorrhoea cases, warning that the sexually transmitted infection could become “untreatable” if the trend continues.
Some infections have shown resistance to ceftriaxone, the primary antibiotic used.
More alarmingly, some cases are classified as "extensively drug resistant" (XDR), meaning they don't respond to ceftriaxone or the secondary treatment.
New data from the UK Health Security Agency (UKHSA) reveals a concerning increase in resistant cases. Between January 2024 and March 2025, 17 cases of ceftriaxone-resistant gonorrhoea were reported, 13 in 2024 and four in the first three months of 2025.
This surpasses the total of 16 cases reported across 2022 and 2023.
The UKHSA also reported nine XDR cases during the same 15-month period – six in 2024 and three in 2025. This represents a notable increase from the five XDR cases identified 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 genitals, 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.”
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