Gonorrhea is essentially out of control in many settings and high disease rates are coupled
with the spread of multiresistant gonococci. Increases in quinolone resistance have followed
loss of the penicillins and tetracyclines as useful treatments. Decreasing susceptibility to
third-generation cephalosporins is also reported. Over-reliance on antibiotic treatment as a
disease control measure in settings with high disease rates and poor control of antibiotic
usage is a significant contributor to the antimicrobial resistance reported. Conversely …

The incidence of gonorrhea is increasing in developed countries and remains high
elsewhere. This untenable disease burden, the complication rate in women and newborns,
and the amplification of human immunodeficiency virus transmission that accompanies
gonorrhea makes control of gonococcal disease a priority. However, antibiotic resistance in
Neisseria gonorrhoeae has severely compromised the successful treatment of gonorrhea.
Older therapies are ineffective, whereas those that remain efficacious are unaffordable in …