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Antibiotic resistance can make some sexually transmitted infections harder to treat, but it does not mean treatment is impossible. The clearest example is gonorrhoea, which has developed resistance to several antibiotics used in the past. Because symptoms cannot reliably identify an infection or the right medicine, testing and advice from a qualified healthcare professional are safer than taking leftover, borrowed or unverified antibiotics.
What antibiotic resistance means for an STI
Resistance is a feature of the microorganism, not a change in a person’s body. The U.S. Centers for Disease Control and Prevention (CDC) defines drug resistance as germs developing “the ability to resist, and even defeat, the drugs designed to kill them” in its Drug-Resistant Gonorrhea page, dated February 15, 2024.
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When bacteria survive a medicine that previously worked against them, that medicine may no longer reliably clear the infection. Clinicians then have fewer effective options, and treatment decisions may depend on the infection, the body site, test results, a person’s circumstances and local guidance. Resistance does not mean every STI has the same problem or that all STI treatment has stopped working.
Why gonorrhoea is the leading resistance concern
According to the World Health Organization (WHO), gonorrhoea has developed resistance to multiple antibiotic groups used over roughly 80 years. The affected groups include tetracyclines, macrolides such as azithromycin, sulphonamides and trimethoprim combinations, and quinolones. WHO reports that ciprofloxacin resistance is very high in many countries, azithromycin resistance is increasing, and reduced susceptibility or resistance to cefixime and ceftriaxone continues to emerge.
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WHO’s October 22, 2025 fact sheet says: “Antimicrobial resistance in gonorrhoea has increased rapidly in recent years and has reduced the options for treatment.” In that context, ceftriaxone remains an important treatment, but its effectiveness needs protection and monitoring. CDC describes cephalosporins as the last recommended and effective antibiotic class for gonorrhoea in the United States; WHO says ceftriaxone remains the last effective option in many countries. Country guidance and surveillance matter because the situation is not identical everywhere.
WHO estimated 82.4 million new gonorrhoea cases worldwide among people aged 15–49 in 2020, with an uncertainty interval of 47.7–130.4 million. This is an estimate for 2020, not a count for 2025 or 2026. WHO also cautions that resistance and treatment-failure surveillance is scarce in many lower-resource settings, so available reports do not describe the complete global picture. CDC notes that gonorrhoea culture testing has declined and that reliable susceptibility testing is not available from nonculture specimens; a result from limited surveillance should not be treated as a population-wide rate.
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Does resistance mean gonorrhoea cannot be cured?
No. Resistance narrows treatment options; it does not establish that care is unavailable or that every infection will fail treatment. CDC’s clinical guidance, dated July 11, 2024, recommends a single intramuscular dose of ceftriaxone 500 mg for uncomplicated urogenital, anorectal and pharyngeal gonorrhoea in the United States. That is a U.S.-specific clinical regimen, not a self-treatment instruction or a universal recommendation. A qualified provider must assess the diagnosis and relevant circumstances, and other countries may use different guidance.
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WHO’s updated recommendations from July 17, 2024 cover treatment recommendations for gonorrhoea and chlamydia, syphilis during pregnancy, testing and partner services. Which care is appropriate depends on the infection and local clinical guidance. If symptoms persist after treatment or a provider suspects treatment failure, seek clinical advice rather than repeating or changing antibiotics yourself.
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Why symptoms are not enough to choose a treatment
Different infections can cause similar symptoms, and many STIs cause no symptoms at all. A person cannot reliably identify the organism, infection site or appropriate treatment by appearance or how they feel. Exposure may involve genital, rectal or throat sites, which can affect what testing is needed.
WHO explains that symptom-based syndromic management can both overtreat people and miss infections. Where quality-assured molecular assays are available, WHO recommends diagnosis-guided treatment. Testing plans and services vary by location, so tell the clinic about relevant exposures and ask which sites should be tested under local protocols.
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Why taking leftover or borrowed antibiotics is risky
- You may be treating the wrong cause. Similar symptoms can have different causes, and an infection may be present without symptoms. A guessed medicine may not treat the actual infection.
- The medicine may not fit the infection or circumstances. The right evaluation can depend on the organism, infection site, pregnancy status, allergies and local resistance patterns. A healthcare professional can assess these factors.
- It can delay diagnosis and appropriate care. Using an antibiotic without testing or clinical advice may leave the underlying infection unaddressed. It can also make it harder to know what treatment is needed if symptoms continue.
- Sharing medicine is not partner treatment. A partner may need their own evaluation, testing or specific instructions. A prescription given to one person is not a safe treatment plan for someone else.
Do not use leftover or borrowed antibiotics, buy prescription medicines from unverified sources, or share a prescription. Resistance develops and spreads through complex processes; the evidence summarized here does not quantify how much resistance is caused by one person’s self-medication, so it would be misleading to assign an individual outcome or a numerical risk. The practical point is that unsupervised treatment can be wrong for the infection and can delay the care that is needed.
What to do after a possible exposure, symptoms or a partner’s diagnosis
- Contact a sexual health clinic or qualified healthcare service. Explain whether you have symptoms, may have been exposed, or were told a partner has an STI. Ask how soon to be seen and what testing is appropriate.
- Ask about testing at relevant exposure sites. Follow the clinic’s and local protocols; genital testing alone may not answer questions about rectal or throat exposure.
- Follow the treatment plan you are given. Ask what the medicine is intended to treat, how to take it, what to do if a dose is missed or symptoms continue, and when it is safe to have sex again.
- Ask how partners should be notified and evaluated. WHO identifies partner services as an important part of STI case management because partner treatment can help interrupt transmission and prevent reinfection.
In some U.S. situations and jurisdictions, CDC guidance allows clinician-managed expedited partner therapy. It includes treatment instructions and warnings, and clinical evaluation is indicated in some cases. It is not permission to hand a partner your own leftover medicine or prescription; availability and rules depend on the jurisdiction.
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Resistance prevention is a shared effort
Antimicrobial resistance emerges in bacteria under antimicrobial exposure and can spread between people and communities. WHO notes that gonococcal resistance appeared soon after antimicrobial medicines began to be used and has expanded over decades. It is too simple to explain resistance as merely the result of one person not finishing a course, or to blame a resistant strain on a single individual’s behavior.
Using antibiotics only when prescribed and following the clinician’s instructions supports responsible treatment. Testing, appropriate treatment and partner care also help reduce ongoing transmission and reinfection. For a specific exposure or diagnosis, use the current local STI guidance rather than assuming that advice from another country—or treatment used for another infection—applies to you.
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