How Worried Should You Actually Be About Drug-Resistant Gonorrhea?

You may have heard recently that drug-resistant gonorrhea is out there, which is sufficiently terrifying news. That news comes courtesy of the World Health Organization, which released a report last week stating that the sexually transmitted infection is on the rise around the world, including cases that are resistant to antibiotics.

In case you’re unfamiliar with antibiotic resistance, it’s what happens when an antibiotic has lost the ability to stop or kill bacterial growth, making the bacteria “resistant” to the drug. While that might sound like the plot of a new dystopian horror movie, the concept of antibiotic-resistant gonorrhea is actually a little more complicated (and slightly less terrifying) than it sounds.

There aren’t actually people walking around with incurable gonorrhea.

The definition of “untreatable gonorrhea” varies somewhat from country to country, as there isn’t a standard protocol for verifying and reporting treatment failures, Brian Katzowitz, health communication specialist with the CDC, tells SELF. Studies that test for antibiotic resistance to gonorrhea are mostly done with lab samples of gonorrhea isolates so that researchers can test a sample against specific drugs and see how much of the drug they need to stop growth of the bacteria. If it takes more of a drug to combat a particular gonorrhea isolate, that would show increasing resistance to that drug.

The report specifically states that WHO has found “widespread resistance to older and cheaper antibiotics,” noting that some countries, especially high-income ones where STI surveillance is good, are finding cases of gonorrhea isolates that are untreatable by “all known antibiotics.” This doesn’t mean that these antibiotics won’t work on the infections—just that they’re seeing them become less effective, either in a lab setting or on the first course of treatment.

“There have been a only a few cases, all of which are outside of the U.S., where a patient has not had their infection cured with ceftriaxone (part of the currently recommended dual therapy in the U.S.),” Elizabeth Torrone, Ph.D., M.S.P.H., an epidemiologist in the CDC’s Division of STD Prevention, tells SELF. “In these rare cases, the patients were eventually treated successfully, but the initial treatment failure suggests that resistance to cephalosporins like ceftriaxone is on the horizon.”

Last year, WHO updated their global treatment recommendations to suggest doctors treat gonorrhea with a combination…

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