David G Regan, Ben B Hui, James G Wood, Helen Fifer, Monica M Lahra, David M Whiley. Treatment for pharyngeal gonorrhoea under threat. Lancet,Volume 18, Issue 11, P1175-1177, November 01, 2018. https://doi.org/10.1016/S1473-3099(18)30610-8
The recommended treatment for Neisseria gonorrhoeae infection in most high-income countries is ceftriaxone in conjunction with azithromycin. This dual drug regimen was introduced to limit further development of resistance to ceftriaxone, which is among the last remaining drugs with proven efficacy and safety for the treatment of gonorrhoea. Since 2009, several distinct N gonorrhoeae strains that were resistant to ceftriaxone (minimum inhibitory concentration 0·5–4·0 mg/L) but susceptible to azithromycin, have been reported globally. Before 2017, these cases were sporadic with little evidence of sustained transmission either nationally or internationally.