Antibiotic resistance in Neisseria gonorrhoeae

Clin Infect Dis. 2005 Aug 15;41 Suppl 4:S263-8. doi: 10.1086/430787.


The incidence of gonorrhea is increasing in developed countries and remains high elsewhere. This untenable disease burden, the complication rate in women and newborns, and the amplification of human immunodeficiency virus transmission that accompanies gonorrhea makes control of gonococcal disease a priority. However, antibiotic resistance in Neisseria gonorrhoeae has severely compromised the successful treatment of gonorrhea. Older therapies are ineffective, whereas those that remain efficacious are unaffordable in many high-incidence settings. Penicillins, tetracyclines, and newer macrolides have limited utility, and spectinomycin (and in many parts of the world, quinolones) have been withdrawn because of resistance. Of the usually recommended treatments, only the third-generation cephalosporins, and most notably ceftriaxone, have retained their efficacy, but decreased susceptibility to these antibiotics has also appeared. A sustained decrease in gonococcal disease requires an integrated approach combining improved prevention, better diagnosis, and effective treatment. Without continued commitment and effort, gonorrhea may well become untreatable.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / pharmacology*
  • Anti-Bacterial Agents / therapeutic use
  • Communicable Disease Control / standards
  • Communicable Disease Control / trends
  • Drug Resistance, Bacterial*
  • Female
  • Gonorrhea / drug therapy*
  • Gonorrhea / epidemiology*
  • Gonorrhea / microbiology
  • Humans
  • International Cooperation
  • Male
  • Microbial Sensitivity Tests
  • Neisseria gonorrhoeae / drug effects*
  • Public Health / standards
  • Quality Assurance, Health Care / standards
  • Sexually Transmitted Diseases / drug therapy
  • Sexually Transmitted Diseases / microbiology
  • Sexually Transmitted Diseases / transmission


  • Anti-Bacterial Agents