Antibiotic Resistant Gonorrhea

Looks like there is even more bad news on the horizon with regards to treatment for one of the most common STDs in the world: Gonorrhea.

One of the world’s top medical journals JAMA, recently published a study that found up to 7% resistance of Gonorrhea to Cefixime. Cefixime is one of the last oral antibiotics available to treat Gonorrhea.

Treatment failure was not limited to urethral infections but also applies to pharyngeal (throat) and rectal infections.

The US CDC has in fact already taken this into account and since last year has already changed their treatment guidelines to remove Cefixime from their recommendations of first line treatments. The treatment recommendation for Gonorrhea now is an injection of 250mg Ceftrixone AND Azithromycin OR Doxycycline.

There are more than 100 million cases of proven Gonorrhea infections worldwide each year. Since the 1940’s, Gonorrhea has been on a relentless march down the road of antibiotic resistance. At this point in time, Cephalosporins are the only weapons we have left against it. Now, even this weapon is showing signs of losing effectiveness. There is currently 1 new drug being studied but the pipeline of new antibiotics is fast drying up.

From a practical patient point of view, please make sure you visit your doctor for a test of cure after you have been treated for Gonorrhea. You have to make sure the strain you have is not antibiotic resistant and the treatment was a success. If not, you will need second line treatment. This will not only protect you, it will also protect your partner and overall lead to the slower development of antibiotic resistant Gonorrhea.


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About Dr. Tan
Dr. Tan graduated from the National University of Singapore in 2001. His residency was in the two largest public hospitals in Singapore; Tan Tock Seng Hospital and Singapore General Hospital.

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  1. Florence

    Hello doctor please I’ve been experiencing burning sensation during urinating and yellow discharge I consulted a pharmacy and I was giving doxycyline,mixed potassium citrate,ciprotab,metronidazole,B.complex,mycoten tab
    please this is too much what do you think please?

  2. my external urethra is itching and i met a pharmacist and i was given mixed potassium citrate and ciprofloxacin 500mg, i have taken it for almost three days now and i still feel that itching, what do i do?

    • You should go see a doctor and do some tests to see what your actual problem is and get treated for the real problem.

  3. Hello Dr,
    I had experience pain while urinating for the pass few days and experiencing discharge today. I think i might have gonorrhea and i want to go to your clinic for testing and treatment. i am just curious as to how long will i need to wait for the test result?

    • Test results can take up to 1 week. If the signs and symptoms are obvious, we will not wait for the results to commence treatment. In other words, if after seeing you we think you really have gonorrhea, we will give you the medicines even before the test results are out.

  4. Hi Doctors,
    please I have what seems to be an injury just near my penis, its just in one spot and not spreading. Could it be an STD and what do you recommend I take for it?

    • Apologies but this site is not for medical consultations neither can I make a diagnosis over the internet. Please see your doctor. You are of course welcome to see us at our clinics.

  5. Hi Doc ;
    My urinating is ok. But have white a bit yellowish discharge, thats why i always feel weet. is it possible a gonorrhoea?. What antibiotics i can take?. Thank ypu so much Doc.

    • Yellow discharge is a very typical sign of Gonorrhea. Please see a doctor and get diagnosed and treated. It is very dangerous to self medicate.

  6. Dear doctors,
    I’m having yellowish discharge from my penis and burning sensation when urinating. I was suffering from gonnorhea last time but im cured… now the disease came back just after i had sex with my partner a few days ago. I pretty sure i did not have sex with other woman and So i guess is that she is also suffering from the disease but she doesnt know about it cos she does not show any symptom. So my question is that, can i and my partner come to any hospital or polyclinic to seek for treatment and medication other than the clinic at kelantan lane??

    • Hi zaki,

      It’s not unusual for females to not have any symptoms even though they have gonorrhea. With regards to treatment, you’re right in that both of you will need to be treated to eradicate the disease. You may choose to visit any centre for treatment. However certain medical practices may not deal with STI management as often and so may not be able to offer you the most up-to-date advice and/or treatment. The DSC should be a good place to address your concerns. Alternatively, you are always welcome to visit us to help manage your health problems.

  7. Scare

    Dear Doc,

    I have the pain when urine and white discharge. GP prescribe Doxycycline for 7days and after which it’s stopped but I still feel abit

    • Dr Elaine Loh

      I would advise you get a STD urine screen rather than just treating blindly as your symptoms may be suggesting possibility of STD or urinary tract infection that may not be responsive to Doxycycline alone. However, I am not able to diagnose you without any further information. Hence, best you consult a doctor again for further evaluation as STD that is left untreated can spread and lead to complications.

  8. Dear doctors,
    I’m having yellowish discharge from my penis and burning sensation when urinating. I went to clinic and given tab. cefuroxime 250mg and cap.doxycycline 100mg both for 5 days..finished my medication today. the symptoms are still there but reduced. Should i continue the same antibiotics or change to another?

    • Dear Sadh,

      The first line recommendations from CDC for uretheritis are for intramuscular ceftriaxone and doxycyline for a minimum of 7 days. You will also need to speak to a doctor with regards to testing for the cause of your urethral discharge as well as for the need to screen for other STIs such as HIV. I’d advise you to seek a formal consult and discuss with a doctor regarding your follow-up course of action. You may wish to attend clinics more used to handling STIs

  9. Dear doctors,
    2 weeks ago I have this burning sensation while urinating and white discharge from my genital area.
    Went to see a doc and was given an injection and 2 weeks of doxycycline.
    Today my med finished but I still see abit of discharge stains on my underwear.
    Any explanation or advise?

    • This is the problem when there is no diagnosis and just treatment. You do not even know what the problem was to begin with. At this stage how is it possible to give any kind of advice? Please go back to see your doctor for a follow up.

  10. hi doctors, today wake up found some white liquid from entrance of penis, subsequently went to urine, very pain, checked on net, sounds like gonorrhoea… last having protected sex was 5 days back, appreciate yr advices doctors, is it curable?

    • Hi, sounds like you have an STD and it could be gonorrhoea. You should see a doctor to have a urine test and also antibiotic treatment as soon as possible. Yes it is curable.

  11. hi doc,

    is there any antibiotic/ medicine that can be bought over the counter for gonorrhoea?

    • We strongly advise against self-medicating with anti-biotics. This is actually one of the factors that lead to the breeding of resistant bacteria.

  12. I had some needle like pain in my penis starting last Thursday but no pain when urinating. It got a little worse on Friday so I went to see a doctor. Was told that it could be swelling of nerve cells and I was given some anti-inflammation tablets and Amoxicillin and a mixture labelled as “MPCA”.

    However, I started to feel pain when urinating on Saturday. So I went back to see the doctor on Sunday. And again was told that it’s nothing. And that I should finish the antibiotics course first to see what happens after. I finished it but still the pain is present. Therefore I went to the polyclinic nearby for a checkup. The doctor did a physical check and ask for a mid sample of my urine. Results turned out to be negative. The doctor then prescribed me with Potassium Citrate that’s all without any antibiotics or even pain killers.

    And now the pain is still there when i urinate and i feel my pelvic area aching. It’s the kind of tired aches not sharp pain. I think there is a small amount of discharge as well. It’s not milky or with colour, just clear. But i think it’s a discharge because it stains my underwear. It’s a very small amount.

    I’m not sure whether I should take an Urine test at your clinic. Will I get the test results immediately and be medicated appropriately? It’s bothering me a lot and i cannot concentrate at work.

    • You need to get tested as soon as you can. It sounds very much like a urethritis.

  13. Hi dr when an NAAT PCR test is conclusive for ghoneria thanks

  14. How much is the testing for gonorrhea and if its positive roughly how mch is needed for the medication?

    • drtan

      Testing is between $100 to $160 depending on whether or not we need to do antibiotic sensitivity testing. Medication is about $70 (injection AND tablets). There is also a consultation charge of $35.

  15. As you have mentioned Second line of Treatment.. How long does it take to cure Gonorrhea completely ?
    and approximately how long does it take to cure urethral infections.

    Thank you for the article. it gives the good awareness

    • There is usually very good symptomatic response to Gonorrhea treatment if the treatment works. Sometimes symptoms can even be gone within hours of the treatment. How long a person needs to be on treatment for urethral infections depends on what infection it is and what antibiotic regime is given. It can be as short as a single dose or as long as 2 weeks. For my practice, I would always like to conduct a test of cure after completion of the treatment to confirm full eradication of the organism. Please post follow up questions on

  16. Hi… Sorry, I know it’s not relevant to the title above.

    But I have no where to ask, really sorry.

    I got Griseofulvin (20 tablets, 1 a day, after food, have not complete yet) AND anti itch pills from my doctor one week ago, and Metformin (2 per day, morning and evening after food) from another doctor.

    I don’t dare to take this 2 drugs together so I stopped my Griseofulvin and anti itch pills for 2 days already. Can I take these drugs together??? Thanks in advance!!

    • This forum is not for medical consultations. Please see your doctor.


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