The number of antibiotic-resistant gonorrhoea cases is rising across Europe, according to the European Centre for Disease Prevention and Control (ECDC).
Early detections were mainly sporadic and often travel-associated, but that picture has shifted since 2025, with rising case numbers in several countries and growing evidence of local spread.
In particular, France, Germany, Sweden and the United Kingdom have reported significant increases, while several other countries continue to detect sporadic cases.
Local transmission of drug-resistant gonorrhoea in Europe is a “warning sign we should not ignore,” said Csaba Ködmön, an ECDC microbiology expert.
“While the risk to the general population is currently low, growing resistance reduces the effectiveness of the therapies we rely on today,” he added, warning that treatment options could become increasingly limited if drug-resistant strains continue to spread.
The main treatment is currently ceftriaxone or ceftriaxone in combination with azithromycin. However, the bacteria are becoming increasingly resistant to both drugs, undermining their effectiveness and helping to sustain transmission.
According to the ECDC, importation from outside Europe remains the principal route through which ceftriaxone-resistant strains enter the region.
Southeast Asian countries, such as Cambodia, Indonesia, Thailand and Vietnam, are recognised as major sources of resistant strains that have spread internationally, some of which have caused treatment failures in Europe and North America.
However, the ECDC also warned of increasing evidence of local transmission across Europe. It noted that the rising number of detections could indicate an early phase of expansion and cautioned that there is a risk of further escalation if control measures are not implemented and maintained.
Gonorrhoea is one of the most common bacterial sexually transmitted infections (STIs), caused by the bacterium Neisseria gonorrhoeae. Left untreated, infection can lead to severe complications, including pelvic inflammatory disease, infertility and ectopic pregnancy.
Rising infection rates
Gonorrhoea notification rates in the European region have risen by 303% over the last ten years, the ECDC said.
In 2024, there were 106,331 confirmed cases, the highest number recorded since EU surveillance began in 2009. Globally, an estimated 82 million new cases occur each year among people aged 15 to 49.
However, the ECDC noted that it may not all be attributable to a rise in cases alone, but also to expanded screening and more complete reporting.
Between 2023 and 2024, the overall rate rose, driven mainly by a 7.9% increase among men, while rates fell among women by 8.6%. Rates were highest among men aged 25 to 34 and among women aged 20 to 24.
In 2024, transmission among men who have sex with men accounted for 62% of reported cases, compared with 37% among heterosexual men and women combined.
The ECDC assesses the risk to the general sexually active population as low.
Risk rises to low-to-moderate for people with multiple or frequently changing sexual partners, those who have condomless sex with casual or new partners, and to moderate for those travelling to areas with higher circulation of antibiotic-resistant strains.
