Cases of gonorrhoea have been rising in Australia for at least 2 decades. In 1998 there were 5,582 notifications of gonorrhoea. In 2018, there were 30,885 notifications.

This is a problem, since gonorrhoea, a sexually transmitted illness (STI), can cause infertility both in men and women if left untreated. And because it doesn't always present with symptoms, many people with gonorrhoea don't know they have it.

What is antibiotic resistance?

Antibiotic resistance could be a big contributing factor to the rise in gonorrhoea notifications. Many bacterial infections can be treated with antibiotic medication, but bacteria can change itself to protect against the antibiotic. If this happens, the antibiotic no longer works to fight that particular bacteria. This is known as 'antibiotic resistance'.

When antibiotics no longer work against resistant bacteria, infections take longer to heal, can get worse or lead to more serious problems. Infections are also more likely to spread to other people, and the antibiotic might not work for those people, either.

Introducing the 'super super-bug'

The National Alert System for Critical Antimicrobial Resistance (CARAlert) collects surveillance data on bacteria that resists last-line antibiotics. In other words, bugs that can survive the last type of antibiotics prescribed to patients when other antibiotics didn't work. These bacteria are being dubbed 'super super-bugs'.

According to a 2018 report by CARAlert, the bulk of the rise in gonorrhoea reports has been due to an increase in a strain of antibiotic-resistant gonorrhoea. This strain has come very close to making azithromycin — the antibiotic that's usually prescribed to treat gonorrhoea — powerless against the infection.

Azithromycin-resistant gonorrhoea is the second most commonly reported 'CAR' (critical antimicrobial resistance).

What is gonorrhoea ('the clap'), anyway?

Gonorrhoea, also known as 'the clap', is usually spread by having unprotected sex (vaginal, anal or oral) with an infected person. It can affect the urethra, cervix, anus, throat or eyes, and can cause infertility if left untreated. It's often asymptomatic, but you can learn more about the signs and symptoms of gonorrhoea here.

You can prevent gonorrhoea by practising safe sex. Always use condoms with a water-based lubricant, and dental dams during oral sex, while limiting sexual partners and avoiding sex with someone who has gonorrhoea until they have finished treatment and are cured. You can also get regular STI check-ups.

If you suspect you may have gonorrhoea, talk to your doctor, who may order a test to diagnose the infection (this will involve a swab and/or urine collection).

How you can help prevent antibiotic resistance

Antibiotic resistance can't be totally stopped, but it can be slowed down by using antibiotics sensibly. You can help by:

• not taking antibiotics for a cold or the flu, including cough and sore throat; viruses cause most colds, and antibiotics don't work against viruses
• telling your doctor you only want antibiotics when necessary — such as for serious bacterial infections like pneumonia
• taking your antibiotic as prescribed, and completing the full course
• never saving antibiotics for the next time you're sick
• never taking antibiotics prescribed for someone else
• practising good hygiene to avoid spreading infections

You can learn more about antibiotic resistance by visiting the NPS MedicineWise website.