Super gonorrhea is a sexually transmitted infection in which the bacteria that causes gonorrhea, Neisseria gonorrhoeae, becomes resistant to the antibiotics that are typically prescribed to treat this infection, like azithromycin.

As a result, super gonorrhea is very difficult to treat and remains in the body for longer. There is a higher risk for further complications due the bacteria’s ability to enter the blood stream and reach other organs. The most common symptoms of super gonorrhea include vaginal or penile discharge and pain during urination.

Gonorrhea is a sexually transmitted infection that can be passed on to other people through anal, vaginal or oral sex

Main symptoms

The most common symptoms of super gonorrhea are:

Pain or burning with urination
White-yellow discharge, similar to pus
Increased urinary frequency with possible incontinence
Anal swelling, in cases where the bacteria was transmitted through anal sex
Sore throat, in cases where the bacteria was transmitted through oral sex
Increased risk for pelvic inflammatory disease if left untreated

The symptoms of super gonorrhea present similarly to those of a normal case of antibiotic-sensitive gonorrhea. However, they tend to persist for longer, even after a full course of antibiotics, which can lead to more complications.

Super gonorrhea is difficult to treat, due to its resistance to typical antibiotics. The body can become susceptible to this bacteria if it enters the blood steam and spreads to other organs. Signs that the bacteria is spreading include fever, joint pain and wounds in the arms or legs.

Confirming a diagnosis

A super gonorrhea diagnosis is confirmed by collecting a sample of genital, urethral, anal or pharyngeal secretion and sending it to a lab.

The sample is analyzed with the aim of identifying Neisseria gonorrhoeae, which is the bacteria responsible for gonorrhea. An antibiogram is then performed to check the sensitivity and resistance profile of this bacteria against antibiotics.

Common causes

Super gonorrhea is caused by Neisseria gonorrhoeae bacteria that has undergone mutations to resist the antibiotics that are usually effective for treating this infection.

This resistance occurs due to the incorrect use of antibiotics (wrong dosing or treatment durations), which allows the bacteria to develop mechanisms of adaptation and eventual resistance to antibiotics.

Treatment options

Treatment for super gonorrhea can be difficult due to its resistance to antibiotics that are typically prescribed for this bacteria (mainly azithromycin and ceftriaxone). To combat antibiotic-resistant Neisseria gonorrhoeae bacteria, doctors will often need to prescribe a combination of antibiotics to be administered intravenously.

It is common for an antibiogram to be ordered to confirm which antibiotics the bacteria is resistant and sensitive to, and to identify the therapeutic dose required to fully eliminate the bacteria.

The doctors will likely continue to order follow-up testing during treatment to determine whether treatment is effective or if the infection is worsening.

Learn more about the most common STIs and how they are treated.