Multidrug-resistant gonorrhoea: tackling a meaner bug in the UK.

Commentary Background Reports of a gonorrhoea 'superbug' made the headlines last year following the description of a ceftriaxone-resistant i solate of Neisseria gonorrhoeae. 1 But is antimicrobial resistance a significant problem and what is the current reality of N. gonorrhoeae infection in the UK? Is gonorrhoea getting meaner? Anogenital infection with N. gonor-rhoeae has been highly responsive to single-dose antimicrobial treatment since the introduction of penicillin. However, the progressive development of resistance by N. gonorrhoeae to many classes of antimicrobial has necessitated periodic changes in treatment recommendations to maintain treatment efficacy and led to ever diminishing treatment options. Third-generation cephalosporins, notably ceftriaxone and cefixime, have been the mainstay of treatment recommendations since 2004. Surveillance data in the UK show a progressive drift in the minimum inhibitory concentrations (MICs) of ceftri-axone and cefixime to N. gonorrhoeae,