The Scottish Bacterial Sexually Transmitted Infections Reference Laboratory (SBSTIRL) provides surveillance data on antimicrobial resistance for all gonococci isolated in Scotland. In this report, resistance data for 2018 are presented.
Continued surveillance of antibiotic resistance is essential for guiding the choice of effective therapeutic regimens for gonorrhoea; this is highlighted by the increase in the number of isolates demonstrating high-level azithromycin resistance, and the reports of extensively drug-resistant (XDR) gonorrhoea in England and Australia in 2018. Given changing resistance patterns, the UK guidelines for the treatment of gonococcal infection were amended during 2019 from azithromycin and ceftriaxone dual therapy to ceftriaxone monotherapy. To optimise resistance surveillance, every effort should be made to maintain culture from a high proportion of gonococcal episodes of infection.