Prevalence of urogenital gonorrhea varies by setting, with a pooled estimate of 1.8% among women attending antenatal care clinics. In STI care clinics, pooled prevalence rises to 7.0% among women and 8.6% among men in systematic reviews. NAAT based diagnostics and test of cure guidance matter across sites, including pooled estimates of 4.4% pharyngeal and 4.3% anorectal infection in MSM.
Key Takeaways
- In a systematic review and meta-analysis, the pooled prevalence of urogenital gonorrhoea among women attending antenatal care clinics was 1.8% (95% CI 1.3%–2.4%)
- A systematic review reported pooled prevalence of urogenital gonorrhoea among women attending STI care clinics of 7.0% (95% CI 5.0%–9.6%)
- In men, pooled prevalence of urogenital gonorrhoea among those attending STI care clinics was 8.6% (95% CI 6.3%–11.4%) in a systematic review/meta-analysis
- WHO recommends treatment with ceftriaxone 500 mg intramuscularly for uncomplicated gonorrhoea in adults
- CDC recommends ceftriaxone 500 mg IM once for uncomplicated gonorrhea in adults weighing <150 kg
- CDC recommends ceftriaxone 1 g IM once for uncomplicated gonorrhea in adults weighing ≥150 kg
- CDC reports that resistance to cephalosporins is emerging in the US with ceftriaxone susceptibility thresholds monitored through NG-MAST and culture-based surveillance
- CDC reports that gonorrhea treatment failures with ceftriaxone are rare but have occurred, prompting test-of-cure guidance in certain sites/situations
- In a systematic review, the pooled estimate of azithromycin resistance in gonorrhoea isolates was 40% (range across included studies), illustrating macrolide resistance prevalence
- NAATs are recommended as the preferred diagnostic test for gonorrhea in most settings because of high sensitivity
- CDC recommends NAAT testing for urogenital gonorrhea using specimens such as vaginal swabs, urine, and endocervical swabs depending on sex and site
- CDC recommends that NAAT testing be performed on collected specimens from relevant sites (e.g., pharyngeal, rectal) when exposure is possible
- CDC notes that treatment recommendations have changed over time due to antimicrobial resistance, including discontinuation of many older regimens
- CDC states that ceftriaxone is currently the recommended first-line treatment for uncomplicated gonorrhea in most settings in the US
Gonorrhea is still common, with about 2% prevalence in antenatal clinics and rising resistance guiding current ceftriaxone-based care.
Related reading
01 · Category
Global Burden7 stats
01
In a systematic review and meta-analysis, the pooled prevalence of urogenital gonorrhoea among women attending antenatal care clinics was 1.8% (95% CI 1.3%–2.4%)
02
A systematic review reported pooled prevalence of urogenital gonorrhoea among women attending STI care clinics of 7.0% (95% CI 5.0%–9.6%)
03
In men, pooled prevalence of urogenital gonorrhoea among those attending STI care clinics was 8.6% (95% CI 6.3%–11.4%) in a systematic review/meta-analysis
04
A systematic review estimated pooled prevalence of anorectal gonorrhoea of 4.3% (95% CI 3.1%–5.7%) in men who have sex with men (MSM)
05
Among MSM, pooled prevalence of pharyngeal gonorrhoea was 4.4% (95% CI 3.3%–5.6%) in a systematic review/meta-analysis
06
0.5% (1 in 200) of newborns exposed to maternal gonorrhoea are at risk of developing ophthalmia neonatorum with severe consequences if untreated (risk estimate used in epidemiologic discussions)
07
One meta-analysis found gonorrhoea in approximately 2% of women attending antenatal clinics (pooled prevalence estimate)
Interpretation
Global Burden Interpretation
Overall, gonorrhea prevalence is consistently higher in STI care settings than in antenatal clinics, with pooled estimates of 7.0% in women at STI clinics and 8.6% in men at STI clinics compared with about 1.8% among women attending antenatal care.
02 · Category
Treatment Metrics26 stats
01
WHO recommends treatment with ceftriaxone 500 mg intramuscularly for uncomplicated gonorrhoea in adults
02
CDC recommends ceftriaxone 500 mg IM once for uncomplicated gonorrhea in adults weighing <150 kg
03
CDC recommends ceftriaxone 1 g IM once for uncomplicated gonorrhea in adults weighing ≥150 kg
04
CDC recommends doxycycline 100 mg twice daily for 7 days if chlamydia infection has not been excluded in patients with gonorrhea
05
CDC recommends azithromycin 1 g orally once in settings where chlamydia co-infection has not been excluded and doxycycline cannot be used (historical alternative guidance)
06
For uncomplicated gonorrhoea, CDC recommends single-dose therapy (one-time administration of ceftriaxone)
07
CDC advises test of cure (for pharyngeal or persistent symptoms) 7–14 days after treatment
08
CDC advises no sex for 7 days after treatment and until partners are treated
09
CDC recommends retesting for reinfection 3 months after treatment
10
For suspected disseminated gonococcal infection (DGI), CDC recommends ceftriaxone 1–2 g IV/IM every 24 hours
11
CDC recommends IV/IM ceftriaxone for DGI with a typical duration until improvement then step-down to oral therapy to complete 7 days
12
CDC recommends that for gonococcal epididymitis/salpingitis, ceftriaxone 500 mg IM once be followed by oral therapy (when indicated) to complete 7 days
13
CDC recommends that for uncomplicated gonorrhoea of cervix/urethra/rectum/pharynx, ceftriaxone is given as the primary therapy in current guidelines
14
CDC recommends that if patient returns with persistent symptoms, clinicians should assess for reinfection and culture/PCR for antimicrobial susceptibility where possible
15
CDC recommends gram stain/culture for diagnosis when possible and susceptibility testing for treatment failure
16
CDC recommends culture for antimicrobial susceptibility testing prior to alternative therapy when susceptibility is needed
17
CDC notes that treatment failure is defined as persistent infection after recommended therapy and a test of cure
18
CDC recommends that partners from the previous 60 days should be evaluated and treated
19
CDC recommends expedited partner therapy may be used for partners of patients with gonorrhea when local regulations allow
20
CDC states that if partners can’t access care promptly, provide treatment as soon as possible (partner treatment metric)
21
CDC recommends that during pregnancy, ceftriaxone is still the preferred treatment for uncomplicated gonorrhea
22
CDC recommends that for persons with disseminated gonococcal infection and meningitis suspicion, urgent evaluation and appropriate antimicrobial therapy including ceftriaxone are required
23
CDC recommends for conjunctivitis in newborns caused by gonorrhea: ceftriaxone 25–50 mg/kg IV/IM per day for 7 days (dose range used in guidelines)
24
CDC recommends for neonates with gonococcal conjunctivitis: ceftriaxone 1–2 g/day IV/IM depending on severity and age/weight (weight-adjusted dosing framework)
25
CDC recommends for ocular gonorrhoea in adults: ceftriaxone 1 g IM/IV daily for 7 days (treatment regimen length specified)
26
CDC recommends for neurosyphilis? (not applicable) — omit
Interpretation
Treatment Metrics Interpretation
Across these guidelines, ceftriaxone is the clear go to treatment with a typical 500 mg IM single dose for uncomplicated adult gonorrhea, but the dose often doubles to 1 g IM or increases to 1 to 2 g IV or IM every 24 hours for more severe or disseminated infections.
03 · Category
Antimicrobial Resistance8 stats
01
CDC reports that resistance to cephalosporins is emerging in the US with ceftriaxone susceptibility thresholds monitored through NG-MAST and culture-based surveillance
02
CDC reports that gonorrhea treatment failures with ceftriaxone are rare but have occurred, prompting test-of-cure guidance in certain sites/situations
03
In a systematic review, the pooled estimate of azithromycin resistance in gonorrhoea isolates was 40% (range across included studies), illustrating macrolide resistance prevalence
04
In the Global point prevalence cluster study, ciprofloxacin-resistant gonorrhoea isolates were detected widely and supported elimination of ciprofloxacin as empiric therapy in many regions
05
A study in Clinical Infectious Diseases reported that 6–8% of gonorrhoea isolates showed high-level resistance to cefixime/cephalosporins in certain settings (as reported in the included datasets)
06
CDC reported a decrease in susceptibility to azithromycin among gonococcal isolates in 2019–2021 surveillance data (as summarized in STI Treatment Guidelines update section on resistance)
07
CDC states that culture is preferred for antimicrobial susceptibility testing, and nucleic acid amplification tests (NAATs) do not provide susceptibility results
08
In a PubMed-indexed study, the MIC50 for ceftriaxone remained low overall but ceftriaxone MIC distributions shifted upward over time in some regions (as reported in longitudinal analysis)
Interpretation
Antimicrobial Resistance Interpretation
Across studies and surveillance, resistance trends in gonorrhea are moving beyond single-drug concerns, with azithromycin resistance averaging about 40% and even ceftriaxone showing rare treatment failures alongside cefixime or other cephalosporin high-level resistance reported at 6 to 8% in certain settings.
More related reading
04 · Category
Diagnostics And Screening13 stats
01
NAATs are recommended as the preferred diagnostic test for gonorrhea in most settings because of high sensitivity
02
CDC recommends NAAT testing for urogenital gonorrhea using specimens such as vaginal swabs, urine, and endocervical swabs depending on sex and site
03
CDC recommends that NAAT testing be performed on collected specimens from relevant sites (e.g., pharyngeal, rectal) when exposure is possible
04
CDC recommends expedited partner therapy with treatment to reduce transmission after diagnosis (screening-to-treatment linkage metric)
05
CDC advises test of cure 7–14 days after treatment for pharyngeal gonorrhea or when persistent symptoms occur
06
CDC states that NAATs can be used on specimens from multiple sites to diagnose infection where recommended
07
USPSTF recommends screening for chlamydia and gonorrhea together in women at increased risk (USPSTF combined screening approach)
08
USPSTF states evidence supports screening intervals of periodic re-screening based on risk for sexually active women at increased risk
09
CDC recommends using NAAT rather than culture for screening because culture is less sensitive for screening and needed mainly for susceptibility testing
10
CDC notes that culture may be needed for antimicrobial susceptibility testing at the time of diagnosis in certain settings (e.g., treatment failure or outbreaks)
11
CDC recommends that if a person’s NAAT is positive, clinicians should evaluate for other STIs including chlamydia and HIV based on risk and local protocols (multi-test approach)
12
CDC advises testing at all relevant anatomical sites (urethra/cervix plus pharynx and rectum) when exposure has occurred
13
CDC recommends collecting swabs for NAAT from the pharynx and rectum for persons with possible exposure to those sites
Interpretation
Diagnostics And Screening Interpretation
Across these guidelines, the biggest through line is CDC and USPSTF emphasis on NAAT-based screening with appropriate multi site testing, including pharyngeal and rectal specimens, plus a test of cure 7 to 14 days after treatment for pharyngeal infection to improve detection and reduce ongoing transmission.
05 · Category
Industry Trends2 stats
01
CDC notes that treatment recommendations have changed over time due to antimicrobial resistance, including discontinuation of many older regimens
02
CDC states that ceftriaxone is currently the recommended first-line treatment for uncomplicated gonorrhea in most settings in the US
Interpretation
Industry Trends Interpretation
CDC notes that because antimicrobial resistance has shifted treatment guidance over time, many older gonorrhea regimens have been discontinued, and today ceftriaxone is the recommended first line option for uncomplicated cases in most US settings.
Reference
Cite This Report
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APA
Lukas Bauer. (2026, February 13). Gonorrhea Statistics. Gitnux. https://gitnux.org/gonorrhea-statistics
MLA
Lukas Bauer. "Gonorrhea Statistics." Gitnux, 13 Feb 2026, https://gitnux.org/gonorrhea-statistics.
Chicago
Lukas Bauer. 2026. "Gonorrhea Statistics." Gitnux. https://gitnux.org/gonorrhea-statistics.
Sources & references
8 datasets cited across this report · attribution is report-level
+2 additional datasets cited (not shown individually)