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Drug-resistant gonorrhoea is becoming an increasing concern across Europe, with Ireland recording higher resistance to older antibiotics.
In separate statements published last week, the European Centre for Disease Prevention and Control (ECDC) warned that drug-resistant strains of gonorrhoea are spreading across Europe, while Ireland’s Health Protection Surveillance Centre (HPSC) reported increased resistance to several older antibiotics among gonorrhoea samples tested in Ireland during 2025.
The ECDC said an increasing number of European countries have detected strains resistant to ceftriaxone, the first-line antibiotic used to treat gonorrhoea. It said there has also been growing evidence over the past two years of local transmission of these resistant strains within Europe.
According to the agency, many of the early ceftriaxone-resistant cases detected in Europe have been linked to importation from regions with higher levels of resistant gonorrhoea, particularly South-East Asia.
An ECDC microbiology expert said the trend should not be overlooked.
“Local transmission of ceftriaxone-resistant gonorrhoea in Europe is a warning sign we should not ignore,” said Csaba Ködmön.
“While the risk to the general population is currently low, growing resistance reduces the effectiveness of the therapies we rely on today. If highly drug-resistant strains become established and continue to spread, treatment options could become increasingly limited.
“Strengthening prevention, expanding antimicrobial testing, and promoting timely diagnosis are therefore essential to detect resistant strains early, limit further spread, and keep gonorrhoea treatable.”
Separately, the HPSC’s latest antimicrobial resistance surveillance report found that resistance to several older antibiotics increased in Ireland during 2025.
Resistance to tetracycline increased from 49% of samples tested in 2024 to 60% in 2025, while resistance to ciprofloxacin rose from 54% to 69%. Signs of resistance to penicillin also increased, rising from 25% to 35% of samples.
Meanwhile, reduced sensitivity to azithromycin changed very little, falling slightly from 28% of samples in 2024 to 26% in 2025.
The HPSC said these findings reinforce why older antibiotics are no longer routinely recommended for the treatment of gonorrhoea and highlighted the importance of continued antimicrobial resistance monitoring.
It added that surveillance data helps ensure treatment recommendations remain effective while supporting the early detection of emerging resistance trends.
The ECDC said the overall risk from ceftriaxone-resistant gonorrhoea remains low for the general sexually active population across the European Union and European Economic Area.
However, it said the risk is higher for people who have sex with multiple casual or new partners, “sex workers” (i.e. prostitutes) and their clients, and people travelling to regions where drug-resistant strains are more common and engaging in promiscuous sex.
The ECDC said gonorrhoea is one of the world’s most common bacterial sexually transmitted infections, with an estimated 82 million infections each year. More than 106,000 confirmed cases were reported across the EU and EEA in 2024, the highest annual total recorded since European surveillance began in 2009.
If left untreated, gonorrhoea can lead to complications including pelvic inflammatory disease, infertility and ectopic pregnancy.
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