There’s good news and bad news in the world of hard-to-treat gonorrhea. In July, 2017, I wrote a column about three cases of antibiotic-resistant gonorrhea. It must have made quite an impression because folks still ask me about it frequently. Here’s what we know now.

BAD: Since 1985, we have been routinely treating gonorrhea with two antibiotics given at the same time, each as a single dose. We were doing this for two reasons. The first is that we already knew that gonorrhea was becoming increasingly hard to treat, so we were hitting it extra hard. We were also using two different antibiotics because chlamydia and gonorrhea are often present at the same time, and they respond to different treatments. This practice of always using two antibiotics to treat a single bacteria is partially responsible for the creation of the antibiotic resistant gonorrhea superbug we’re now trying to contain.

GOOD: In December, 2020, the CDC released new treatment guidelines for gonorrhea. These guidelines state that we should only be using a single antibiotic unless chlamydia is present. There is new guidance on which antibiotics to use as well. Ceftriaxone is now the treatment of choice, still given in a single dose (as an injection in the buttock). The CDC is also recommending increased evaluation of clinical specimens to determine which antibiotics are effective and which will no longer work.

BAD: Antibiotic resistant gonorrhea is still out there, and is still evolving beyond our routine antibiotic regimen.

GOOD: A three-day course of a relatively new antibiotic called ertapenem (given via IV) is effective at treating the most virulent strains of gonorrhea. Researchers are currently doing more investigations to see if this antibiotic might be an effective stopgap until we have new antibiotics available.

BAD: On a global level, we need to be spending more money on research and development of new antibiotics if we’re going to stay on top of this superbug and others like it.

GOOD: The global fight against the novel coronavirus SARS-CoV-2 (aka COVID-19) has proven that we’ve got a lot of pharmaceutical muscle to flex if we can just commit to it.

BAD: Gonorrhea (and many other STIs) can be spread during vaginal intercourse, anal intercourse, and oral sex, and between people of all genders and biological sex.

GOOD: There are so many great forms of barrier protection available. If you get comfortable using barriers, there’s so much fun you and your partner(s) can have!

Curious about cunnilingus? Anxious about anal? Do you have questions about queefs or problems with your prostate? Lucky Tomaszek is the education coordinator at The Tool Shed: An Erotic Boutique, Milwaukee’s only mission-driven, education-focused sex toy store. Send her an email at [email protected] and she’ll get back to you with an answer.

About The Author

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Lucky Tomaszek, LM, CPM, is the education coordinator at The Tool Shed: An Erotic Boutique, Milwaukee's only mission-driven, education-focused sex toy store. Most mornings you can find her balancing her cat and her keyboard in her lap, working to make the world a smarter, safer place for people of all genders and orientations.