Scientists have found the first new antibiotic treatment for gonorrhoea since the 1990s amid fears over the rise of “untreatable” strains of the sexually transmitted infection.
Gepotidacin, an antibiotic currently used to treat urinary tract infections, can also treat gonorrhoea, experts have found.
It comes after researchers warned last month that gonorrhoea could become “impossible to treat” as antibiotic-resistant infections continue to rise.
The research, published in The Lancet on Monday, compared the treatment of 622 patients for gonorrhoea with the current standard injected antibiotic, called ceftriaxone, with a new treatment using an oral antibiotic pill, gepotidacin.
They found the pill to be as effective as the current standard treatment and also found it worked against the strains of the STI Neisseria gonorrhoeae that are resistant to existing antibiotics.
An editorial published alongside the study warned that global targets to reduce the number of new cases of gonorrhoea among people aged 15 to 49 from 82.3 million per year in 2020 to 8.23 million per year in 2030 might not be achieved due to the resistant strains.
It added: “There is the risk that soon gonorrhoea will be impossible to treat in the absence of new drugs or strategies to curb the burden of disease … What we are seeing with N gonorrhoeae is a challenge that could extend easily to other bacteria with worsening of the antimicrobial resistance landscape.”
The study was carried out by researchers from Birmingham University Hospitals, Leeds Teaching Hospitals NHS Trust, Emory University, Louisiana State University Health Sciences Center, Sydney Medical School, and pharmaceutical company, GlaxoSmithKline (GSK) which manufactures gepotidacin.
Authors note that resistant strains are prevalent in several Asian countries, and have been increasingly confirmed across Europe.
Last month, the UK Health Security Agency published an alert over the rise in antibiotic-resistant gonorrhoea cases and “extensively” drug-resistant strains.
Since 2015, there have been 42 cases of ceftriaxone-resistant gonorrhoea and 15 of those were extensively resistant, meaning they were also resistant to second-option treatments.
From January 2024 to March 2025, nine cases of the super-resistant strain were recorded, compared to five cases in two years prior.
Cases of antibiotic-resistant gonorrhoea come after a record 85,000 cases were reported in England in 2023, and a rise in STI diagnosis more broadly in the UK.
Researchers said: “Cases of drug-resistant gonorrhoea have increased rapidly in recent years, reducing the options for treatment. There is an urgent need for new treatments for gonorrhoea with no new antibiotics since the 1990s.
“The new treatment could be an important tool in combating the rise of gonorrhoea strains that are becoming resistant to the standard treatment. Additionally, treatment as a pill alone without the need for an injection would likely improve patient experiences and reduce healthcare resources.”
However, researchers advised the study results must be treated with caution as the majority of the participants, 74 per cent, were white men and so said more research would be needed for the impact on women, adolescents and other ethnicities.
In a comment piece, the authors also warned that strains resistant to gepotidacin will develop and said the development of additional treatments remains important.
They said: “In conclusion, gepotidacin is promising for the treatment of gonorrhoea, but the challenges to retain gonorrhoea as a treatable infection will continue. As emphasised by WHO, five key priorities crucial for effective management and control of gonorrhoea include improved prevention.”
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