You’ve probably heard the term "super gonorrhoea" being discussed in the news recently. There’s been talk of it since an outbreak in Leeds last September, but more recent reports have reignited the conversation. So what’s the story behind this dramatically named disease, and how at-risk is the average person?

The first thing to know is that super gonorrhoea is not a more aggressive or complicated form of gonorrhoea. The "super" refers to the fact that the bacterial infection is resistant to a certain type of antibiotic, making it far harder to cure. Ultimately, this means that the symptoms of gonorrhoea will progress, potentially leading to more serious complications such as pelvic inflammatory disease, ectopic pregnancy, and infertility in women; and infection in the testicles or prostate in men.

Common gonorrhoea symptoms include unusual discharge from the penis or vagina and pain or a burning sensation when urinating. Men may also experience swelling of the foreskin, and women may experience irregular bleeding. If you are experiencing any of these symptoms, you should get an STI test as soon as possible.

What is antibiotic resistance?

Antibiotic resistance refers to any strain of bacterial infection that can no longer be cured with antibiotics. This is very problematic, as it means life-threatening bacterial infections that have long been treated with antibiotics could suddenly become very difficult to cure.

What causes antibiotic resistance?

When you take a course of antibiotics, it should kill off all the bacterial infection it is targeting. Sometimes, however, the antibiotics do not kill off all the bacteria, and the ones that survive reproduce. This creates a new strain that is slightly more resistant to the antibiotic than that which was killed off.

The key thing to know about antibiotic resistance is that it only refers to bacterial infections, and not to individual people. It is not possible to make yourself resistant to antibiotics, but often this misunderstanding leads patients to stop a course of antibiotics early in an effort to avoid developing a resistance. In actual fact, finishing a course of antibiotics early is one of the things contributing to antibiotic resistance. For this reason, it is crucial always to finish a full course of antibiotics that you have been prescribed.

Antibiotic Resistance in Super Gonorrhoea

In the case of super gonorrhoea, the bacterial infection causing gonorrhoea has developed a resistance to the common antibiotic azithromycin. The theory is that this resistance has partly been caused by people discreetly ordering gonorrhoea treatment over the internet from online pharmacies.

The established treatment for gonorrhoea in the UK is two doses of antibiotics; an injection of ceftriaxone, and a single high dose of azithromycin tablets. When patients order gonorrhoea treatment online instead of going to a doctor, they will be given cefixime tablets as an alternative to the injection. The tablets are not as effective in treating the infection, which puts more of a burden on azithromycin to fight the bacteria, resulting in the gonorrhoea developing a new strain resistant to the azithromycin.

Avoiding Super Gonorrhoea

A recent report by Public Health England showed that there were 34 cases of azithromycin-resistant super gonorrhoea in the UK between November 2014 and April 2016.

The medical community currently thinks that the best way to tackle super gonorrhoea is to focus upon high-risk groups. This includes people who change sexual partners frequently, men who have sex with men, and sex workers. If you fall into one of these groups, it’s important to be rigorous about practising safe sex. That means always wearing condoms when you aren’t sure that your partner is free from sexually transmitted infections.

It’s also important to get tested regularly, which you can do through the NHS or by ordering a home gonorrhoea test kit from us at The STI Clinic.

If you are diagnosed with gonorrhoea, you should not order treatment over the internet unless there really is no alternative in your personal circumstances. Instead, you should go to a sexual health or GUM clinic, or visit your doctor. They will be able to administer the necessary ceftriaxone injection, which will give you maximum protection against the infection.

While it is not advised that you receive gonorrhoea treatment over the internet, it is perfectly safe to get tested through reputable websites, such as this one.