One of these cases appears to have contracted in Europe and the other has links to Europe but was acquired in the UK. A case of resistant gonorrhea was contracted in South East Asia by a UK national in 2018. This was a different type of resistance and unrelated. They believe ceftriaxone should remain the first line treatment for gonorrhea; with gentamicin as an alternative particularly for patients with genital infection; those who are allergic or intolerant to ceftriaxone.

The treatment of gonorrhea

But further research is requiring to identify and test new alternatives to ceftriaxone for the treatment of gonorrhea.” In the trial, performed in 14 sexual health clinics in England; 720 participants randomized to receive either injection of gentamicin or the current treatment of ceftriaxone intravenously; with both groups also given a single dose of azithromycin by mouth.  Overall 98% of participants given ceftriaxone had their gonorrhea cured, compared to 91% given gentamicin; a difference of 7%.

Therefore, it is likely that doctors will continue to use ceftriaxone (plus azithromycin); as their preferred treatment. Gentamicin did have a cure rate of 94% for genital gonorrhea and so it might be useful when ceftriaxone is not available; or inappropriate to use. The study also indicates that current widely used treatment of 1 gram azithromycin; used in combination with both drugs, is probably not enough to prevent resistance developing; its use globally as part of dual combination therapy for gonorrhea should reviewed.

If treated early gonorrhea is unlikely to lead to any complications or long-term problems. However, without treatment, it can spread to other parts of the body and cause serious health issues. In women, the infection can spread to the reproductive organs and cause pelvic inflammatory disease (PID). This is estimated to occur in 10 to 20 % of cases of untreated gonorrhea. PID can lead to long-term pelvic pain; ectopic pregnancy, and infertility.

Baby born with conjunctivitis

During pregnancy, the condition can cause miscarriage; premature labor and the baby born with conjunctivitis. If the baby is not promptly treating with antibiotics, there’s a risk of progressive damage to vision. In men, gonorrhea can cause a painful infection in the testicles and prostate gland.
“The NIHR is to research in areas of greatest health need; such as antimicrobial resistance. This research is one of a number of studies we’ve funded over the last few years in this vital area; in our sustained effort to tackle this worldwide threat.” The researchers say further research into developing a preventative or therapeutic vaccine is crucial due to increasing resistance and limited future antibiotic options.
They say a greater understanding of the immune response to infection needs to develop; this and that collection of samples in the trial will help with this future research. Exploring how frequently multiple infections occur and their potential role in the spread of resistance is also important. Genome sequencing could help identify genetic markers of gonorrhea resistance and provide insights into the mechanisms and predictors of resistance, they add.