HEALTH bosses have issued an urgent warning over an “extensively drug resistant” STI, over fears it could soon become “untreatable”.
New data compiled by the UK Health Security Agency (UKHSA) showed rising numbers of gonorrhoea cases that didn't respond to antibiotic treatment.
While most gonorrhoea infections can be treated effectively, certain resistant strains “present significant treatment challenges”, the health watchdog said.
It warned that increased resistance could one day make the sexually transmitted infection (STI) “untreatable”;.
Gonorrhoea is usually treated with a single dose of the antibiotic ceftriaxone, given as an injection or tablets at GP surgeries or a sexual health clinics.
But in some cases this isn't effective, as the bacteria has developed the ability to survive and multiply even when exposed to the antibiotic.
“Ceftriaxone-resistant gonorrhoea is of particular concern,” UKHSA scientists said.
“As the primary antibiotic used to treat gonorrhoea, resistance to ceftriaxone can make infections difficult to treat.”
These drug-resistant cases can usually be taken care of with a second line of treatment.
A small number of cases are classed as “extensively drug resistant”; – or XDR – meaning the infection did not respond to ceftriaxone or the second antibiotic.
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.”
Since first being detected in England in 2015, 42 cases of ceftriaxone-resistant gonorrhoea have been reported.
Fifteen of these cases were extensively drug-resistant.
“Although numbers remain low, cases are being detected more frequently,” UKHSA said.
In the 15 months between January 2024 and March 20 this year, 17 cases of ceftriaxone-resistant gonorrhoea were reported – 13 in 2024 and four in 2025 so far.
In contrast, 16 cases of the drug-resistant STI were detected in the two years between January 2022 and December 2023.
Super resistant XDR strains are also being spotted more frequently, with nine cases detected between January 2024 and March this year.
Six XDR cases were spotted last year and three so far into 2025.
This compares to the total of five cases reported between January 2022 and December 2023.
Symptoms of gonorrhoea
Typical symptoms of gonorrhoea include:
- A thick green or yellow discharge from the vagina or penis
- Pain when urinating
- Pain and discomfort in the rectum
- Lower abdominal pain and bleeding between periods in women and other people with a uterus or ovaries
Gonorrhoea can affect other parts of your body that come into contact with semen or vaginal fluid.
This can cause:
- Pain, itching and discharge from your bottom
- A sore throat
- Eye redness, pain and discharge
However, many people infected with gonorrhoea will have no symptoms, especially for infections in the throat, vagina or rectum.
This lack of symptoms makes it important to test regularly when having sex with new or casual partners.
If you do get symptoms, they usually start around two weeks after infection, although they sometimes do not appear until many months later.
Untreated gonorrhoea can lead to serious health complications including:
- Infertility and pelvic inflammatory disease (PID)
- An infection of the female reproductive system, which includes the womb, fallopian tubes and ovaries
- An infection in the testicles or prostate
Having gonorrhoea during pregnancy can increase your risk of premature birth and your baby having a low birth weight.
There's also a risk the infection could spread to your baby's eyes during birth, which is called gonococcal conjunctivitis.
This can cause blindness if it’s not treated with antibiotics.
Most cases were linked to travel to or from the Asia-Pacific region, where ceftriaxone-resistance is common.
UKHSA noted that transmission within England has been limited so far, but it still found the increasing number of cases in recent years concerning as it increases the chance of wider spread and treatment challenges.
Health bosses have issued repeated warnings about rising cases of gonorrhoea and other STIs in England.
The latest provisional data from sexual health services showed that approximately 54,965 cases of gonorrhoea were diagnosed in the first nine months of 2024, compared to over 85,000 recorded in the whole of 2023.
Though infections are now starting to level, they still remain high, UKHSA noted.
Meanwhile, around 7,000 syphilis cases were recorded between January and September 2024, compared to 9,513 in the whole of 2023.
Untreated infections can lead to serious, irreversible complications affecting the brain, heart, and nerves.
Both gonorrhoea and syphilis are easily transmissible, especially if you're having unprotected sex.
Dr Sinka said: “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.”
If you're having condomless sex with new or casual partners, regular testing for STIs and HIV is essential.
You can get tested at local sexual health clinics, university and college medical centres or through self-sampling kits ordered online and sent discreetly through the post.
