Gonorrhea has tripled in Catalonia in four years and responds increasingly poorly to antibiotics
A study published this April in the European Journal of Clinical Microbiology & Infectious Diseases confirms what health authorities have been warning for months: the incidence of gonorrhea in Catalonia has increased by 236% since 2019 and has already reached 152.7 cases per 100,000 inhabitants in the period 2022-2023. In other words, in just four years the cases have more than tripled. |
The research, prepared by professionals from the Public Health Agency of Catalonia together with the Vall d’Hebron University Hospital and the Centre for Epidemiological Studies on STIs and AIDS, analyses more than 23,000 laboratory-confirmed cases during 2022 and 2023. And it not only warns of the increase in infections: it also confirms that the antibiotics that had traditionally been used to treat the disease are working less and less.
What is gonorrhea and why is it a concern now?
Gonorrhea is a sexually transmitted infection caused by a bacterium called Neisseria gonorrhoeae . It is transmitted through unprotected sexual contact—vaginal, anal, or oral—and can affect both the genitals and other areas such as the throat or rectum.
Many people go through it without clear symptoms, and that’s part of the problem: if it’s not treated quickly, it can cause serious complications, especially in women, because it increases the risk of ectopic pregnancy and infertility. In men, it can cause pain when urinating, unusual discharge and, in advanced cases, affect the urethra, the urinary tract of the penis .
Which antibiotics no longer work well?
This is where the study focuses. Researchers have found that three of the antibiotics that have historically been used against gonorrhea have very high levels of resistance:
- Ciprofloxacin: no longer works in 71% of cases. Seven out of ten patients do not respond to this drug.
- Tetracycline: fails in almost half of the cases analyzed (49%).
- Azithromycin: one in five cases (20%) is resistant to it. This is particularly worrying because it was part of the combination therapy used until recently.
The less bad news is that ceftriaxone —the current antibiotic of choice— continues to be effective in almost 100% of cases. But, as the same study explains, bacteria develop resistance the more they are exposed to drugs: if infections continue to grow, the margin for finding effective treatments is getting shorter.
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“When we talk about antibiotic resistance, it’s not an abstract problem. It means that, if we don’t act, in a few years we could be faced with sexual infections that are common today and that we no longer know how to treat. That’s why early detection and prevention are so important.” Dr. Salvador Esquena · urologist at UROCAT |
Who is at greater risk?
The study also identifies patterns where resistance is more common. Infections in people aged 25 and older are more resistant to ciprofloxacin, tetracycline and penicillin. And infections detected outside the genitals—especially in the anal canal—have higher rates of resistance to multiple antibiotics.
This has a direct implication: if only the genital area is tested, infections in other locations that are equally contagious and potentially more difficult to treat may be overlooked.
What can you do?
Prevention remains the most effective weapon:
- Use a condom in all sexual practices (vaginal, anal and oral). It is the most effective measure to prevent infection.
- Get tested regularly if you have different sexual partners, even if you don’t have symptoms. Many STIs are asymptomatic.
- Request a complete screening that includes samples from all areas that may be affected, not just the genitals.
- Consult quickly if you experience symptoms such as discomfort when urinating, unusual secretions or pain in the genital, anal or throat area.
- Inform sexual partners in the event of a positive diagnosis, so that they can also be treated and break the chain of transmission.
At UROCAT we can help you
If you have symptoms that may indicate a urinary tract infection or sexually transmitted infection, or simply want to get screened for peace of mind, schedule a visit with our urology team. Getting checked on time not only protects your health: it also helps stop the spread of resistant strains that are increasingly difficult to treat.
Sources used
- Herrero, M. et al. (2026). Trends and risk factors of antimicrobial resistance of Neisseria gonorrhoeae in Catalonia, Spain, 2022–2023. European Journal of Clinical Microbiology & Infectious Diseases.
- Public Health Agency of Catalonia. Increase in cases of gonorrhea resistant to antibiotics in Catalonia (notice of April 9, 2026).
- Diumenjó, A. (15/04/2026). Gonorrhea triples in Catalonia and is increasingly resistant to antibiotics. Diari Ara.
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