Super Gonorrhoea breakthrough as new antibiotic works against mutant STI on the rise in Britain

A breakthrough new antibiotic has been discovered to help tackle the rise of super gonorrhoea. Scientists have found the first new antibiotic treatment for gonorrhoea since the 1990s as a worrying number of mutant strains become resistant to other forms of the lifesaving drug.

The UK Health Security Agency (UKHSA) warned last month that if this antibiotic resistance is not tackled it could make the sexually transmitted infection (STI) "untreatable". It follows wider warnings that antimicrobial resistance could one day see antibiotics stop working and common operations become fatal. A study in the Lancet has revealed gepotidacin is as effective against uncomplicated gonorrhoea as current standard antibiotics. Using it could now reduce circulating strains which are resistant to standard drugs.

The UKHSA says the STI known as "the clap" is increasingly becoming resistant to the main antibiotic used by the to treat it. Health chiefs say most UK cases are linked to travel to Asia-Pacific countries such as Thailand but the increase raises the risk of significant spread within England.

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The news of a new drug to tackle the infection - which affects over 80 million people worldwide every year - are being presented at the congress of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID).

The study concludes: “Effective treatments have diminished due to the global spread of antimicrobial-resistant gonorrhoeae. Gepotidacin is a novel oral antibacterial treatment with the potential to become an alternative option for the treatment of gonococcal infections. The introduction of such an agent could mark a meaningful advancement in patient care.”

Gepotidacin is an antibiotic currently used to treat urinary tract infections so is readily available to NHS doctors. Researchers compared it with the current standard treatment of ceftriaxone with azithromycin in 628 patients. They found that the new pill is as effective as ceftriaxone with azithromycin for treating the standard infections and was also found to be able to treat strains resistant to current first-line treatments.

Speaking last month, Dr Katy Sinka, Consultant Epidemiologist and head of the STI section at UKHSA, said: "Gonorrhoea is becoming increasingly resistant to antibiotics, which could make it untreatable in future. If left untreated, it can cause serious problems like pelvic inflammatory disease and infertility.” Dr Sinka said the best protection is to use a condom as pelvic inflammatory disease can infect the womb, fallopian tubes and ovaries.

There were 85,000 gonorrhoea diagnoses reported in England in 2023, up 7.5% from 79,000 diagnoses in 2022, and the highest since records began in 2018. The UKHSA last month released latest data showing 54,965 gonorrhoea diagnoses at sexual health services in the first nine months of 2024.

Symptoms include painful urination, abdominal pain, yellow or green discharge, bleeding in between periods and pain or swelling in the testicles. However many people infected with gonorrhoea will have no symptoms so the UKHSA says it is vital to test regularly when having sex with new or “casual partners”.

Neisseria gonorrhoeae, the bacteria that causes gonorrhoea, appears on the UKHSA's list of viruses and bacteria which pose the greatest threat to public health.

The number of cases of Super Gonorrhoea is small but growing. Ceftriaxone is the primary antibiotic used to treat gonorrhoea and since first being detected in England in 2015 there have been 42 cases of resistant gonorrhoea reported. Worryingly 15 of these cases were extensively drug-resistant, which means that they were resistant to ceftriaxone and to second line treatment options.

In the 15 months from January 2024 to 20 March 2025, there were 17 cases of ceftriaxone-resistant gonorrhoea reported - 13 in 2024 and 4 in 2025 so far. This compares to 16 across the previous two years during 2022 and 2023. Super Gonorrhoea is generally considered to be the extensively drug-resistant (XDR) form and this is also on the rise. From January 2024 to March 2025 there were 9 XDR cases. This compares to 5 cases in total in the previous two years.

Dr Sinka added: "The best way to stop STIs is by using a condom. If you've had condomless sex with a new or casual partner, get tested, whatever your age, gender or sexual orientation. This includes when you are having sex abroad. Early detection not only protects your health but prevents transmission to others. Many STIs show no symptoms, which is why regular testing is so important. Testing is quick, free and confidential."

One in five bloodstream infections are now resistant to one or more antibiotics. England’s previous chief medical officer Sally Davies warned “the is facing an antibiotic apocalypse” if the drugs were not stopped being overused and new versions developed.