Antibiotic resistance continues to hinder effective treatment of gonorrhoea. In 2003, 9.0% of gonococcal isolates in England and Wales were resistant to standard ciprofloxacin therapy. (In the West Midlands the prevalence of ciprofloxacin resistance was more than double that seen in any other region, at 21%.) In Scotland, resistance increased from 11% in 2002 to 15% in 2003.1

As a result, guidelines now recommend the use of third generation cephalosporins (ceftriaxone or cefixime) in place of fluoroquinolones or penicillin as first line therapies.1