On October 27, 2026, the CDC released its 2026 Antimicrobial Resistance Threats Report, and drug-resistant gonorrhea is once again on the short list of "urgent" threats. It sits alongside Candida auris, carbapenem-resistant Acinetobacter and carbapenem-resistant Enterobacterales as one of four pathogens CDC puts in its highest category, and it was also an urgent threat in CDC's 2013 and 2019 reports.

The short version: the antibiotic CDC currently recommends for gonorrhea still works, and resistance to it remains very rare. What the report underlines is why that matters, and why testing, treating partners and following up after treatment are the everyday tools that protect it.

What CDC reported about gonorrhea

According to CDC's drug-resistant gonorrhea page in the new report:

• More than 740,000 drug-resistant infections a year. CDC says the estimated number of drug-resistant gonorrhea infections in the US has stayed above 740,000 since 2018. It adds that the ranges around each year's estimate overlap, so year-to-year changes should be read cautiously.
• Resistance to at least one of six antibiotics rose. Among gonorrhea samples tested, resistance or elevated resistance levels to any of six antibiotics (azithromycin, ceftriaxone, cefixime, ciprofloxacin, tetracycline and penicillin) fell to a low of 47.8% in 2022, then rose to 55.4% in 2023. CDC says the 2022-to-2023 increase was driven by drugs that are no longer recommended for gonorrhea, including tetracycline, penicillin and ciprofloxacin. It will keep monitoring to see whether this is a one-time blip or the start of a trend.
• Ceftriaxone resistance is still very rare. Ceftriaxone is the current recommended treatment, and CDC says resistance to it "remained very rare" from 2018 to 2023.
• Nearly $215 million in lifetime medical costs for drug-resistant infections in 2023, according to CDC's estimate.

CDC also cautions that it changed its methods and data sources for this report, so numbers shouldn't be compared directly with earlier reports.

Why the treatment that still works matters

CDC's gonorrhea page says the bacteria have developed resistance to nearly all antibiotics used for treatment and that only a few antibiotics still work, so "access to antibiotics that successfully treat these infections is critical." CDC's STI treatment guidelines explain how we got here: fluoroquinolones were dropped as a recommendation in 2007, cefixime lost its first-line status, and today only ceftriaxone, a single injection given in a clinic, is recommended for uncomplicated infections. Alternatives exist for people who are allergic to it or can't get the injection, but CDC notes that some are less effective, especially for throat infections. That is one reason clinicians watch closely for any sign of treatment failure.

The same guidelines say people with gonorrhea and HIV should receive the same treatment as people without HIV. CDC's report page also notes that gonorrhea can increase the risk of getting and giving HIV, which is one reason the topic matters for this community.

A rare complication appeared in two states

The report highlights disseminated gonococcal infection (DGI), a rare, severe complication that CDC says may develop when gonorrhea goes untreated. Between 2023 and 2024, Alaska's health department detected a DGI outbreak after cases rose nearly four-fold, and in 2024 Minnesota's health department also saw cases rise four-fold. CDC says DGI can lead to septic arthritis, endocarditis, meningitis and bone infection, and that these complications can require hospitalization and surgery.

CDC also lists drug-resistant Mycoplasma genitalium, a sexually transmitted bacterium, on its Watch List of pathogens whose full burden isn't yet understood. CDC says it develops resistance to antibiotics very easily, leaving few effective options.

What this means for testing and partners

Nothing in the report changes the basics. It does reinforce them. According to CDC's treatment guidelines:

• Many infections have no obvious symptoms. Gonorrhea is often silent in women and in the throat, so testing is how many infections are found. CDC recommends routine screening for some groups, such as sexually active women under 25 and men who have sex with men, and a clinician can tell you what fits your situation.
• Other tests belong in the same visit. Anyone diagnosed with gonorrhea should also be tested for chlamydia, syphilis and HIV, and people who test negative for HIV should be offered HIV PrEP.
• Partners should be reached too. Recent sex partners (generally those within the last 60 days) should be referred for evaluation, testing and treatment. CDC says many repeat infections result from partners not being treated or from new infected partners. In some places and situations, clinicians can give a patient treatment to pass to a partner who can't get care quickly (called expedited partner therapy). Rules for this vary by state.
• Follow-up matters. CDC advises waiting 7 days after treatment, and until partners are treated, before sex, and retesting about 3 months after treatment.

CDC's guidelines say symptoms that persist after treatment should be evaluated by a clinician. They also note that most suspected treatment failures in the US are likely to be reinfections rather than true failures.

For more on testing options, see our posts on at-home STD testing and dating and what routine STD testing can miss, and our earlier coverage of why public health officials are monitoring antibiotic-resistant gonorrhea and how treatment options are narrowing.

What it means for doxyPEP

Doxycycline post-exposure prophylaxis, or doxyPEP, comes up in any conversation about gonorrhea and antibiotics, so here is what CDC's guidance says. It's easy to mix up two different things:

• Treatment. CDC's 2024 doxyPEP guidelines state that doxycycline is "currently not a recommended treatment for gonorrhea because of elevated antimicrobial resistance," though it remains effective against many US strains. CDC's recommended treatment for uncomplicated gonorrhea is ceftriaxone, not doxycycline.
• Prevention. The same guidelines recommend that clinicians counsel gay, bisexual and other men who have sex with men and transgender women who had syphilis, chlamydia or gonorrhea in the past 12 months about doxyPEP and offer it through shared decision-making. In three large randomized trials, doxycycline taken after sex reduced syphilis and chlamydia infections by more than 70% and gonorrhea infections by about 50%. CDC says there isn't enough evidence yet to make a recommendation for other groups, including cisgender women and cisgender heterosexual men.

CDC's doxyPEP guidance also says anyone using it should have STI testing every 3 to 6 months, and that resistance in gonorrhea and other bacteria will need to be monitored as use grows. The gonorrhea threat page in the new report doesn't discuss doxyPEP. If you're wondering whether it's right for you, that's a conversation for a clinician. We covered the latest evidence in our post on doxyPEP and syphilis.

Talking about testing when you're dating

Headlines about "superbugs" can make dating feel riskier than it needs to be. Gonorrhea is common and treatable, and getting it says nothing about a person's character. A few ways to keep the conversation easy:

• Treat testing as normal health talk. "When was your last full test, and what did it cover?" works for everyone, whether you're living with HIV, herpes or neither.
• Share what you know, when you're ready. If you test positive, reaching recent partners so they can get tested is a key part of CDC's guidance, and it helps stop reinfection. Nobody should pressure you about timing, details or sex, and you can say no at any point.
• Ask about the whole picture. Standard panels don't always cover everything. Ask what was tested, at which body sites, and when.
• Stay safe meeting new people. Meet in public first, tell a friend where you're going, and keep consent clear and ongoing. Disclosure expectations and legal duties differ by state, so check your state's rules if you have questions.

If a partner has recently been treated, a calm "when can we safely be intimate again?" is a fair question. CDC's guidance on waiting 7 days after treatment, and until partners are treated, is a good starting point to bring to your clinician.

Questions to bring to your clinician

• Which STI tests, at which body sites, make sense for me, and how often?
• If I'm diagnosed, how should my recent partners be reached and tested?
• When should I retest, and when is it safe to have sex again?
• Is doxyPEP something to discuss for me, based on CDC's guidance?

Quick FAQ

Is gonorrhea untreatable now?

No. According to CDC, resistance to ceftriaxone, the current recommended treatment, remained very rare from 2018 to 2023. The concern is that the bacteria have already developed resistance to nearly all other antibiotics used for treatment, so protecting the one that works matters.

Did the number of drug-resistant infections go up in this report?

CDC says the estimate has stayed above 740,000 a year since 2018, with a rise from 2018 to 2021 and a decrease in 2022 and 2023. The ranges overlap, so CDC advises caution in reading year-to-year changes. What did jump was the share of samples resistant to at least one of six antibiotics: from 47.8% in 2022 to 55.4% in 2023.

Does doxyPEP treat gonorrhea?

No. CDC says doxycycline is not a recommended treatment for gonorrhea. CDC does recommend counseling certain groups about doxyPEP as a way to lower the risk of getting some bacterial STIs, and it still calls for regular testing.

The bottom line

CDC's 2026 report keeps drug-resistant gonorrhea in its "urgent" category and shows that overall resistance climbed in 2023, but the treatment CDC recommends still works. Regular testing, treating partners, and following up after treatment are how people and clinics help keep it that way. Honest, low-drama talk about testing is part of dating well, and you deserve partners who feel the same. If you're ready to meet people who get it, explore STD dating on MeetPositives.

Sources

• CDC, Antimicrobial Resistance Threats Report, "Drug-resistant Neisseria gonorrhoeae" and "Antimicrobial Resistance Threats" pages, October 27, 2026 (arpsp.cdc.gov).
• CDC, Sexually Transmitted Infections Treatment Guidelines, 2021, "Gonococcal Infections Among Adolescents and Adults," and CDC, "Clinical Treatment of Gonorrhea" (cdc.gov).
• Bachmann LH, et al. CDC Clinical Guidelines on the Use of Doxycycline Postexposure Prophylaxis for Bacterial Sexually Transmitted Infection Prevention, United States, 2024. MMWR Recomm Rep 2024;73(No. RR-2):1-8.
• CDC, Antibiotic Resistance Threats in the United States, 2019 (for the earlier urgent-threat listing).

This article is for general information only and is not medical or legal advice. It does not create a doctor-patient relationship. Talk with a licensed health care provider about your own situation. Laws vary by state; for legal questions, talk with a licensed attorney.