Gonorrhea

Gonorrhea, caused by Neisseria gonorrhoeae, is the second most common bacterial STI and results in substantial morbidity and economic cost worldwide. Gonorrhea is spread by having unprotected vaginal, anal, or oral sex with someone who has gonorrhea, or from mother-to-child during childbirth. Correct and consistent use of condoms significantly decreases the risk of sexual transmission.

Gonorrhea is often asymptomatic in women. If untreated, gonorrhea infection may lead to serious complications.


Of all the STIs, gonorrhea is the most antibiotic-resistant. Increased resistance to most antibiotics used to treat gonococcal infections has been reported worldwide, raising concerns about the eventual development of untreatable gonococcal infections with serious sexual and reproductive health consequences.

To the extent possible, countries should update their national guidelines for the treatment of gonococcal infection based on recent antimicrobial resistance (AMR) surveillance. If local ARM surveillance in not yet functional, PAHO urges countries to adopt the latest WHO treatment guidelines for N. gonorrhoeae

Key facts
  • According to the Latin American AMR Surveillance Network (ReLAVRA), ciprofloxacin resistance has steadily grown, with isolates increasing from 35% in 2009 to 62% in 2015. Moreover, reduced sensitivity to broad spectrum cephalosporins and macrolides is beginning to emerge in Latin America and the Caribbean (LAC).
  • While there are documented increases in gonococcal resistance to antimicrobial drugs, only 36% of the countries in the Americas systematically monitor this resistance to support treatment decisions
  • In 2017, only 8% of the countries in LAC reported the use of ceftriaxone plus azithromycin, as recommended in the WHO treatment guidelines.
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