Increasing antimicrobial resistance undermines the effectiveness of treatment

Dr Kevin Fenton

The PHLS set up a scheme to monitor levels of resistance in England and Wales.

Results from the first year of the scheme show substantial levels of resistance to the two main drugs used to treat gonorrhoea, ciprofloxacin and penicillin.

PHLS scientists were surprised at the high levels of resistance to ciprofloxacin - the most commonly used treatment - in some regions.

Overall, 1.8% of bacteria samples showed resistance to the drug.

But in the Northern and Yorkshire region the figure was 6.5% and in the North West it was 4.4%.

Penicillin resistance was found in 9.4% of samples.

Undermine

Dr Kevin Fenton, a consultant epidemiologist at the PHLS, said: "Despite this resistance, appropriate antibiotic treatment should cure all uncomplicated infections.

"However, increasing antimicrobial resistance undermines the effectiveness of treatment and means that the range of drugs available to treat the disease is reduced.

"It is vital that those who are infected seek treatment, because if left untreated complications can occur such as pelvic inflammatory disease, chronic pelvic pain, ectopic pregnancy or infertility.

"Infection during pregnancy may lead to spontaneous abortion, stillbirth or neonatal complications."

Gonorrhoea is most common in men aged 20-24, women aged 16-19 and gay and bisexual men.

Cases of gonorrhoea have been increasing since 1994, and in 2000 over 20,000 new diagnoses were made in clinics in England and Wales, a 27% increase between 1999 and 2000.

Diagnosis in gay and bisexual men rose by 45% over the same period of time.

Public health concern

The rise in cases, combined with increasing antibiotic resistance and the fact that gonorrhoea infection can occur with no symptoms makes it a major public health concern.

The infection can be transmitted through full or oral sex.

Gonorrhoea can appear with no symptoms, leaving people unaware of their infection.

If symptoms occur in women they can include a painful and burning sensation when passing urine or discharge from the vagina that is yellow or bloody.

These symptoms will occur within 2-10 days of becoming infected.

Men more frequently present with symptoms which can include a discharge from the penis and a severe burning pain when passing urine.