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Ceftriaxone-Resistant Gonorrhea in Europe

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What changed

2026-08-13 22:10 UTC → 2026-08-14 09:51 UTC · added ~~removed~~

In mid‑July 2026, the European Centre for Disease Prevention and Control (ECDC) confirmed that the rise in gonorrhoea cases resistant to the first‑line antibiotic ceftriaxone is a pan‑European phenomenon. The 2024 EU total of more than 106,000 infections—the highest since 2009—included a growing share that failed ceftriaxone treatment, with the most pronounced increases in France, Germany, Sweden, and the United Kingdom. Evidence now confirms a shift from travel-related cases to domestic community transmission. The ECDC identified domestic cases in 12 countries during 2025 and early 2026. In Sweden, seven of 13 resistant infections were recorded as locally acquired, and the Public Health Agency of Sweden has implemented a special monitoring program as local transmission chains establish. Germany reported travel-free cases in 2026, and Norway logged a linked pair in April 2026. The United Kingdom saw resistant cases rise from 13 in 2024 to 29 in 2025, including six documented treatment failures. In August 2026, Sweden was identified by the ECDC as a country of particular concern. Microbiologist Thomas Åkerlund of the Public Health Agency of Sweden reported a significant increase in resistant bacteria within the country, suggesting the establishment of local infection chains. In 2025, Sweden detected nine resistant cases, while four have been identified so far in 2026, exceeding the previous average of three per year. The resistant strain primarily shows resistance to ceftriaxone and some resistance to azithromycin. Beyond ceftriaxone, azithromycin resistance is also emerging, contributing to a 303% rise in resistant infections over the last decade. Health officials warn that limited therapeutic options could lead to serious sequelae, such as pelvic inflammatory disease, infertility, and ectopic pregnancy. While the new antibiotic zoliflodacin has shown effectiveness, it is not yet approved in the EU. ~~The ECDC continues to call for intensified surveillance, reinforced testing, and the development of alternative regimens to contain the spread.~~

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