Why is gonorrhoea becoming resistant to antibiotics?
Gonorrhoea bacteria (Neisseria gonorrhoeae) are unusually good at picking up genetic changes that let them survive antibiotics, and this has been happening in stages for decades. Doctors used to treat gonorrhoea with penicillin, then with other antibiotic classes, and each time resistance eventually caught up. The current first-line treatment in the UK is a single ceftriaxone injection, because it still reliably clears most infections. Strains that resist ceftriaxone as well are the ones making headlines as "super gonorrhoea", and they matter because there are very few antibiotic options left once first-line treatment stops working.
Is super gonorrhoea common in the UK?
No. The UK Health Security Agency monitors gonorrhoea resistance closely and has reported only a small number of cases resistant to first-line treatment, so this remains uncommon here. It is still worth taking seriously, because gonorrhoea remains one of the most commonly diagnosed STIs in England, and more infections mean more chances for a resistant strain to spread. That is the practical reason testing and proper treatment matter for everyone, not just for people who might have a resistant strain.
Does having a resistant strain change my symptoms?
No. A resistant strain looks and feels exactly like ordinary gonorrhoea. Many people, especially women, have no symptoms at all. When symptoms do appear, they typically include discharge from the penis or vagina, pain or burning when urinating, and in women, bleeding between periods; a fuller run-through is in our guide to gonorrhoea symptoms. You cannot tell from symptoms alone whether a strain will respond to standard treatment; that only becomes clear from testing.
How does testing for gonorrhoea work?
Testing uses a urine sample, or a swab, including from the throat or rectum if you have had oral or anal sex. At Sexual Health Clinic London this is £104, with results in 3 days (2 to 3 days for a throat swab); you can walk in seven days a week at 117a Harley Street or book ahead, as part of our private STI testing in London service. If you want a wider check, gonorrhoea is included in every screening package, starting with Bronze at £250. If you need an answer the same day, the FAST Screen Simple on our same-day screen covers gonorrhoea, chlamydia, HIV and syphilis for £350, with results in 6 hours, using a urine sample or a swab rather than a throat swab.
The table below sets out what changes, and what doesn't, when a strain is resistant.
Resistant gonorrhoea compared with a standard infection:
Why does a test of cure matter more with gonorrhoea?
Because resistance means treatment cannot simply be assumed to have worked, UK guidance recommends a test of cure for everyone treated for gonorrhoea, whether or not symptoms have settled. The retest is done 2 weeks after treatment, using a urine or swab test. Retesting confirms the antibiotic actually did its job. If a repeat test is still positive, it may mean the infection has not cleared, possibly because the strain is resistant, or that there has been a new infection; your clinician will arrange further testing and a different antibiotic if needed, ideally guided by a laboratory sensitivity result.
What should I do if I've been treated and I'm still getting symptoms?
Symptoms that persist after finishing your antibiotics should not be left to settle on their own; book a repeat test rather than waiting. Persisting symptoms after treatment are one of the clearest signs a strain may not have responded fully, and continuing to have sex in the meantime risks passing it on. Tell your clinician you have already been treated once, since that changes which antibiotic they consider next.
How do I avoid contributing to resistance?
The things within your control are testing regularly if you're sexually active, taking any treatment exactly as prescribed, and going back for your test of cure. Treating yourself with leftover antibiotics, or antibiotics bought online, is one of the ways resistant strains get a foothold, because the wrong drug or dose may not clear the infection. Partner notification also matters: if a partner has an infection that later turns out to be resistant, testing them promptly stops it circulating further.
How testing works at our Harley Street clinic
A gonorrhoea test at our clinic is £104, taken as a urine sample or a swab depending on your symptoms, with results back in 3 days. For a urine sample, avoid passing urine for 2 hours before the test. We contact you confidentially with your results, and if you test positive a clinician will advise on treatment and on your test of cure 2 weeks after treatment. Walk-in appointments are available seven days a week at 117a Harley Street, or you can book online in advance.
If you would rather not wait, the FAST chlamydia and gonorrhoea urine test is £124, with results in 6 hours. Our guide to same-day STI test results explains the FAST options.
Book a gonorrhoea test at 117a Harley Street: £104, results in 3 days, confidential walk-in or booked appointments.
References
- Gonorrhoea, NHS
- UK national guideline for the management of gonorrhoea in adults, British Association for Sexual Health and HIV (BASHH)
- Gonococcal antimicrobial resistance surveillance, UK Health Security Agency (UKHSA)
- Gonorrhoea, NICE Clinical Knowledge Summaries
