Lessons learnt from ceftriaxone-resistant gonorrhoea in the UK and Australia.

Neisseria gonorrhoeae, the causative pathogen of gonorrhoea, has shown impressive agility in developing resistance to successive classes of antimicrobials used for therapy, leading to a progressive reduction in available treatment options. Ceftriaxone is the last-line treatment option for gonorrhoea, and many countries recommend dual therapy with ceftriaxone (250–1000 mg) in combination with azithromycin (1–2 g). However, since the introduction of dual therapy, the global prevalence of azithromycin resistance has increased. Additionally, the extensively drug-resistant N gonorrhoeae FC428 clone, which is associated with ceftriaxone resistance and intermediate resistance to azithromycin, has been reported to have spread internationally, with epidemiological links to the Asia-Pacific region.