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Antibiotic resistance can make some sexually transmitted infections harder to treat, but it does not mean that treatment is impossible. Gonorrhoea is the clearest example: resistance has reduced the number of antibiotics that reliably work, so testing and clinician-directed care matter. Don’t take leftover or borrowed antibiotics for a suspected STI; the right care depends on the infection, the site involved and local guidance.
What antibiotic resistance means for STI treatment
Resistance is a property 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 bacteria or other germs developing “the ability to resist, and even defeat, the drugs designed to kill them.” When resistant bacteria survive a medicine that once worked, that medicine may no longer treat the infection reliably.
Resistance can emerge under antimicrobial exposure and spread between people and communities. Gonococcal resistance appeared soon after antimicrobial medicines came into use and has expanded over roughly 80 years, according to the World Health Organization (WHO). It is not accurate to reduce this history to a single person failing to finish a course, or to say that one person’s behaviour alone creates a resistant strain.
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Gonorrhoea is the leading resistance example in STI care. WHO reports that resistance has affected several antibiotic groups used historically against it, including tetracyclines, macrolides such as azithromycin, sulphonamides and trimethoprim combinations, and quinolones. In many countries, ciprofloxacin resistance is very high; azithromycin resistance is increasing; and reduced susceptibility or resistance to cefixime and ceftriaxone continues to emerge.
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WHO’s 2025 fact sheet estimates that there were 82.4 million new gonorrhoea cases worldwide among people aged 15–49 in 2020, with an uncertainty interval of 47.7–130.4 million. That is an estimate for 2020, not a count for 2025 or 2026. WHO also cautions that surveillance and treatment-failure data are scarce in many lower-resource settings, so reported resistance does not capture the full worldwide picture.
In the U.S. context, CDC describes cephalosporins as the last recommended and effective antibiotic class for gonorrhoea. WHO says ceftriaxone remains the last effective option in many countries. Those statements underline why resistance is monitored; they are not a reason to select an antibiotic yourself. Surveillance and local treatment guidance are important because resistance patterns and recommendations can differ by place and change over time.
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Does resistance mean gonorrhoea can’t be cured?
No. Resistance narrows treatment options; it does not mean there is no care. 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. This is a U.S.-specific clinician-directed recommendation, not a general prescription: a qualified provider must assess the person and relevant circumstances. It should not be applied automatically to another country, another infection, pregnancy, an allergy or suspected treatment failure.
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Resistance also is not the same problem for every STI. WHO’s updated recommendations of July 17, 2024 cover gonorrhoea, chlamydia, syphilis during pregnancy, testing and partner services. The appropriate evaluation and treatment depend on the suspected or confirmed infection and applicable local guidance; a gonorrhoea treatment recommendation cannot be used as a menu for other infections.
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Why symptoms are not enough to choose treatment
Many STIs cause no noticeable symptoms. When symptoms do occur, similar symptoms can have different causes, and symptoms alone may not show which infection is present or which body site needs testing. WHO notes that symptom-based syndromic management can both overtreat people and miss infections. Where quality-assured molecular assays are available, WHO recommends diagnosis-guided regimens.
Testing and treatment decisions may need to reflect the exposure site, such as the genital area, rectum or throat, along with local protocols. Ask the healthcare service what testing is appropriate for your situation rather than assuming one test or a symptom check covers every possible infection.
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Why you shouldn’t take leftover or borrowed antibiotics
Self-medicating can delay the right diagnosis and expose you to a drug that is unsuitable for the infection, site, pregnancy status, allergies or local resistance pattern. A medicine that is wrong for the cause may not resolve the infection. Buying prescription drugs from an unverified source adds another risk: you may not know whether the product or its use is appropriate.
- Don’t use leftover antibiotics or take someone else’s prescription for a possible STI.
- Don’t share prescription medicines, even if another person has similar symptoms.
- Don’t treat a suspected infection by choosing from a list of antibiotics online.
- Contact a qualified healthcare service for testing and treatment advice.
These are diagnostic and medication-safety reasons to avoid self-treatment. Available evidence here does not quantify how much resistance is caused by any one person’s self-medication, so it would be misleading to attach a specific amount or outcome to an individual case.
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How to get tested and treated
- Contact a sexual health clinic or qualified healthcare service. Do this if you may have been exposed, have symptoms or have a partner who was diagnosed. Tell the clinician about relevant symptoms, possible exposure and any medicines or allergies.
- Ask what testing fits your situation. The appropriate tests can depend on the infection, exposure site and local protocols. A clinician can advise whether testing should include genital, rectal or throat sites.
- Follow the treatment plan you are given. Use only clinician-directed treatment. Ask when it is safe to have sex again and what follow-up, if any, is needed.
- Ask how partners should be notified and evaluated. Partner care can help interrupt transmission and prevent reinfection. Follow local clinical advice about notification and treatment.
Why partner care is part of treatment
Treating the person who first seeks care may not be enough to prevent an infection from circulating or returning. WHO identifies partner treatment as an important part of STI case management. Ask the clinic how partners can be informed, tested and treated under the rules where you live.
In the United States, expedited partner therapy may be an option in some situations and jurisdictions. CDC describes it as clinician-managed care that includes treatment instructions and warnings, with personal medical evaluation where indicated. It does not authorize sharing leftover antibiotics or a prescription with a partner.
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