The United States has precisely one antibiotic recommended for the treatment of gonorrhea. That antibiotic is ceftriaxone. And according to new global data from the World Health Organization's Enhanced Gonococcal Antimicrobial Surveillance Program, resistance to that last-line treatment rose more than sixfold between 2022 and 2024 across the 13 countries whose data feed into WHO's international gonorrhea surveillance network. The data were published in late 2025 and continue to circulate in the medical literature as public health officials worldwide grapple with what they are calling a potential untreatable STI scenario.
To understand the gravity of this trajectory, it is necessary to understand the history that produced it. Gonorrhea, caused by the bacterium Neisseria gonorrhoeae, has developed resistance to virtually every antibiotic class that has ever been used to treat it. Sulfonamides, penicillin, tetracycline, fluoroquinolones such as ciprofloxacin, and cephalosporins such as cefixime have all been abandoned as reliable treatments over the past 80 years as gonorrhea evolved resistance. The current situation leaves ceftriaxone as the sole CDC-recommended option — a single point of failure in a bacterium with a well-established evolutionary track record of escaping treatment.
