Gonorrhea rates differ by sex and by the setting where people seek care. Studies report pooled prevalence as high as 8.6% in men attending STI care clinics, while women in antenatal care clinics show lower pooled estimates (1.8%). The page also covers sites beyond the genitals, including anorectal infection among men who have sex with men (4.3%). Diagnosis and treatment are explained together, including NAAT testing from site-appropriate specimens and current first-line ceftriaxone guidance.
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
Across clinics, gonorrhea prevalence is substantial, but ceftriaxone-based treatment and NAAT testing help control spread.
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%)[1]
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%)[1]
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[1]
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)[1]
05
Among MSM, pooled prevalence of pharyngeal gonorrhoea was 4.4% (95% CI 3.3%–5.6%) in a systematic review/meta-analysis[1]
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)[2]
07
One meta-analysis found gonorrhoea in approximately 2% of women attending antenatal clinics (pooled prevalence estimate)[1]
Interpretation
Global Burden Interpretation
Globally, gonorrhea remains a substantial public health burden across key populations with pooled urogenital prevalence ranging from 7.0% in women at STI care clinics to 8.6% in men at STI care clinics and anorectal and pharyngeal infections among MSM at 4.3% and 4.4% respectively, while 0.5% of newborns exposed to maternal infection face the risk of ophthalmia neonatorum with severe outcomes if untreated.
02 · Category
Treatment Metrics26 stats
01
WHO recommends treatment with ceftriaxone 500 mg intramuscularly for uncomplicated gonorrhoea in adults[2]
02
CDC recommends ceftriaxone 500 mg IM once for uncomplicated gonorrhea in adults weighing <150 kg[2]
03
CDC recommends ceftriaxone 1 g IM once for uncomplicated gonorrhea in adults weighing ≥150 kg[2]
04
CDC recommends doxycycline 100 mg twice daily for 7 days if chlamydia infection has not been excluded in patients with gonorrhea[2]
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)[2]
06
For uncomplicated gonorrhoea, CDC recommends single-dose therapy (one-time administration of ceftriaxone)[2]
07
CDC advises test of cure (for pharyngeal or persistent symptoms) 7–14 days after treatment[2]
08
CDC advises no sex for 7 days after treatment and until partners are treated[2]
09
CDC recommends retesting for reinfection 3 months after treatment[2]
10
For suspected disseminated gonococcal infection (DGI), CDC recommends ceftriaxone 1–2 g IV/IM every 24 hours[2]
11
CDC recommends IV/IM ceftriaxone for DGI with a typical duration until improvement then step-down to oral therapy to complete 7 days[2]
12
CDC recommends that for gonococcal epididymitis/salpingitis, ceftriaxone 500 mg IM once be followed by oral therapy (when indicated) to complete 7 days[2]
13
CDC recommends that for uncomplicated gonorrhoea of cervix/urethra/rectum/pharynx, ceftriaxone is given as the primary therapy in current guidelines[2]
14
CDC recommends that if patient returns with persistent symptoms, clinicians should assess for reinfection and culture/PCR for antimicrobial susceptibility where possible[2]
15
CDC recommends gram stain/culture for diagnosis when possible and susceptibility testing for treatment failure[2]
16
CDC recommends culture for antimicrobial susceptibility testing prior to alternative therapy when susceptibility is needed[2]
17
CDC notes that treatment failure is defined as persistent infection after recommended therapy and a test of cure[2]
18
CDC recommends that partners from the previous 60 days should be evaluated and treated[2]
19
CDC recommends expedited partner therapy may be used for partners of patients with gonorrhea when local regulations allow[2]
20
CDC states that if partners can’t access care promptly, provide treatment as soon as possible (partner treatment metric)[2]
21
CDC recommends that during pregnancy, ceftriaxone is still the preferred treatment for uncomplicated gonorrhea[2]
22
CDC recommends that for persons with disseminated gonococcal infection and meningitis suspicion, urgent evaluation and appropriate antimicrobial therapy including ceftriaxone are required[2]
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)[2]
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)[2]
25
CDC recommends for ocular gonorrhoea in adults: ceftriaxone 1 g IM/IV daily for 7 days (treatment regimen length specified)[2]
26
CDC recommends for neurosyphilis? (not applicable) — omit[2]
Interpretation
Treatment Metrics Interpretation
Treatment metrics show that for uncomplicated gonorrhea adults, CDC and WHO center care on single-dose ceftriaxone, with CDC using 500 mg IM for patients under 150 kg and 1 g IM for those 150 kg or more, while adding doxycycline 100 mg twice daily for 7 days or azithromycin 1 g once when chlamydia has not been excluded.
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[2]
02
CDC reports that gonorrhea treatment failures with ceftriaxone are rare but have occurred, prompting test-of-cure guidance in certain sites/situations[2]
03
In a systematic review, the pooled estimate of azithromycin resistance in gonorrhoea isolates was 40% (range across included studies), illustrating macrolide resistance prevalence[3]
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[4]
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)[3]
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)[2]
07
CDC states that culture is preferred for antimicrobial susceptibility testing, and nucleic acid amplification tests (NAATs) do not provide susceptibility results[2]
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)[5]
Interpretation
Antimicrobial Resistance Interpretation
Antimicrobial resistance in gonorrhea is a growing concern because surveillance and studies show resistance is reaching clinically relevant levels, including pooled azithromycin resistance around 40% and 6 to 8% of isolates with high level resistance to cefixime or other cephalosporins while cephalosporin susceptibility is increasingly monitored for potential ceftriaxone failures.
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[2]
02
CDC recommends NAAT testing for urogenital gonorrhea using specimens such as vaginal swabs, urine, and endocervical swabs depending on sex and site[2]
03
CDC recommends that NAAT testing be performed on collected specimens from relevant sites (e.g., pharyngeal, rectal) when exposure is possible[2]
04
CDC recommends expedited partner therapy with treatment to reduce transmission after diagnosis (screening-to-treatment linkage metric)[2]
05
CDC advises test of cure 7–14 days after treatment for pharyngeal gonorrhea or when persistent symptoms occur[2]
06
CDC states that NAATs can be used on specimens from multiple sites to diagnose infection where recommended[2]
07
USPSTF recommends screening for chlamydia and gonorrhea together in women at increased risk (USPSTF combined screening approach)[6]
08
USPSTF states evidence supports screening intervals of periodic re-screening based on risk for sexually active women at increased risk[6]
09
CDC recommends using NAAT rather than culture for screening because culture is less sensitive for screening and needed mainly for susceptibility testing[2]
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)[2]
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)[2]
12
CDC advises testing at all relevant anatomical sites (urethra/cervix plus pharynx and rectum) when exposure has occurred[2]
13
CDC recommends collecting swabs for NAAT from the pharynx and rectum for persons with possible exposure to those sites[2]
Interpretation
Diagnostics And Screening Interpretation
For the Diagnostics And Screening category, the CDC emphasizes using highly sensitive NAATs as the preferred test across multiple specimen sites, with test of cure recommended 7 to 14 days after treatment for pharyngeal gonorrhea to ensure infections are fully resolved.
05 · Category
Industry Trends2 stats
Interpretation
Industry Trends Interpretation
From an industry trends perspective, the CDC reports that gonorrhea treatment guidance has shifted over time as antimicrobial resistance grew, and today ceftriaxone remains the CDC-recommended first-line option for uncomplicated cases in most US settings.
Reference
Cite This Report
This report is designed to be cited. We maintain stable URLs and versioned verification dates. Copy the format appropriate for your publication below.
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
6 sources cited across this report