Growing Antibiotic Resistance Prompts Updated STI Guidelines

WHO releases new treatment guidelines for chlamydia, gonorrhea, and syphilis

Officials with the World Health Organization (WHO) have issued new guidelines for the treatment of chlamydia, gonorrhea, and syphilis in response to the growing threat of antibiotic resistance.1

These sexually transmitted infections (STIs) often go undiagnosed and are becoming more difficult to treat, with some antibiotics now failing as a result of misuse and overuse. 

Resistance of these STIs to the effect of antibiotics has increased rapidly in recent years and has reduced treatment options. Strains of multidrug resistant gonorrhea that do not respond to any available antibiotics have already been detected. Antibiotic resistance in chlamydia and syphilis, though less common, also exists, according to a statement from WHO. 

The new guideline calls on health authorities to advise physicians to prescribe whichever antibiotic would be most effective to treat gonorrhea, based on local resistance patterns. The new WHO guidelines do not recommend fluoroquinolones for the treatment of gonorrhea due to widespread high levels of resistance.

To treat syphilis, the new guidelines strongly recommend a single dose of benzathine penicillin. This is the most effective treatment for syphilis, as it is more effective and cheaper than oral antibiotics.

Chlamydia is the most common bacterial STI; people with this infection are frequently co-infected with gonorrhea. The guidelines urge countries to update their national guidelines for treatment of chlamydial infection.

It is estimated that, each year, 131 million people are infected with chlamydia, 78 million with gonorrhea, and 5.6 million with syphilis.  

“Chlamydia, gonorrhea and syphilis are major public health problems worldwide, affecting millions of peoples’ quality of life, causing serious illness and sometimes death. The new WHO guidelines reinforce the need to treat these STIs with the right antibiotic, at the right dose, and the right time to reduce their spread and improve sexual and reproductive health. To do that, national health services need to monitor the patterns of antibiotic resistance in these infections within their countries,” Ian Askew, Director of Reproductive Health and Research at WHO said in the statement.


1. Growing antibiotic resistance forces updates to recommended treatment for sexually transmitted infections.[press release].  Geneva, Switzerland; World Health Organization: August 30, 2016