El tratamiento actual recomienda la prescripción de ceftriaxone bajo una estrategia de terapia dual conjuntamente con azithromycin, con al idea de continuar con la efectividad de los medicamentos. Sin embargo, la aparición de la gonorrea resistente a azithromicyn, pone en peligro esta segunda línea de protección ("second lock") lque corrientemente impide o retrasa la aparición de la resistencia a ceftriaxone. Esto significa que se está a apenas un paso de diferencia, con respecto al desarrollo del tratamiento completo para la gonorrhoea resistente.

In April 2016, Public Health England announced a ‘national incident response’ following a new outbreak
of high-level azithromycin resistant gonorrhoea in parts of England.9 There are already a dwindling number of antimicrobials that remain effective in the treatment of gonorrhoea, with ceftriaxone representing the last line of antibiotic treatment for the condition. Current practice recommends that ceftriaxone is prescribed in a dual- therapy approach alongside azithromycin, to maintain the drug’s effectiveness. The emergence however of azithromycin resistant gonorrhoea jeopardises this “second lock” that currently prevents or delays the emergence of resistance to ceftriaxone, meaning that we are one step closer to the development of entirely treatment-resistant gonorrhoea.
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