Professor Magnus Unemo from Örebro University Hospital in Sweden is the world expert on gonorrhea antibiotic resistance.

At the IUSTI conference today he spoke about what is happening with gonorrhea treatment and the disturbing levels of resistance to antibiotics.

Gonorrhea has slowly and steadily become resistant to almost all antibiotics, with some strains recently discovered now untreatable.

The antibiotic, ciprofloxacin that we used just 15 years ago is now useless in Spain, with more than a third of strains now resistant.

Until just 6 years ago we used azithromycin, but the professor showed that levels of resistance are also climbing in Spain and close to a third of cases are now resistant.

However, the standard treatment for gonorrhea (ceftriaxone) is still a good option for us in Spain, as less than 5% of cases show any resistance, and fully resistant strains have not been detected here.

The famous strain called FC428, with full resistance to ceftriaxone has now been seen in Australia, Japan, China, Denmark and France – this is worrying as it will slowly spread and gonorrhea will become untreatable unless there are new options.

In fact there are two new antibiotics being studied now (zoliflodacin and gepotidacin) and clinical trials are doing well, with the vaccine on the horizon. A gonorrhea vaccine is probably our only hope for an effective reduction in cases.

If you need my help to choose the right treatment and not use now useless antibiotics, please book a consultation with me here:


  1. IUSTI congreso de diciembre 2021

2. WHO global antimicrobial resistance surveillance for Neisseria gonorrhoeae 2017–18: a retrospective observational study Unmeno M et al 2021 Lancet Microbe Vol 2, 11, E627-E636