The European Centre for Disease Prevention and Control (ECDC) has launched its public health response plan to control and manage the threat of resistant gonorrhoea across Europe . This is the first regional response plan after the World Health Organization (WHO) warned about drug-resistant gonorrhoea becoming a major public health challenge .
Gonorrhoea poses a serious public health problem as it has developed resistance to several antibiotics and is becoming less susceptible to the last available antibiotics (third-generation cephalosporins).
Results from the European gonococcal antimicrobial surveillance programme (Euro-GASP) show that the percentage of isolates with decreased susceptibility to the recommended drug for treatment of gonorrhoea (cefixime) rose from 4% in 2009 to 9% in 2010. Decreased susceptibility was detected in 17 countries in 2010, seven more than in the previous year. At the same time, the susceptibility to the injectable drug ceftriaxone is decreasing as well . The loss of both cefixime and ceftriaxone as treatment options for gonorrhoea would have a significant impact on public health: gonorrhoea is the second most commonly reported bacterial sexually transmitted infection (STI) in Europe  and its effective control relies entirely on antimicrobial treatment.
To this respect, ECDC launched a public health response plan that has been developed in collaboration with an expert group, including STI microbiologists and the International Union against STI. The goal of the plan is to minimise the impact of resistant gonorrhoea in Europe with the following components:
- strengthening the surveillance of gonococcal antimicrobial susceptibility in European Union/European Economic Area (EU/EEA) Member States to inform national treatment guidelines (including training courses);
- ensuring that a minimum capacity for culture and susceptibility testing at national level in EU/EEA Member States is available or developed;
- establishing a strategy to rapidly detect patients diagnosed with gonorrhoea that experience a clinical treatment failure;
- outlining a set of recommended public health actions at the national level following the detection of resistant cases.
The current level of decreased susceptibility against cefixime is of great concern and it is likely that more treatment failures will be reported. Public health experts and clinicians need to be informed about the current critical situation and should be vigilant for treatment failures.
- European Centre for Disease Prevention and Control (ECDC). Response plan to control and manage thethreat of multidrug-resistant gonorrhoea in Europe. Stockholm: ECDC; Jun 2012. Available from: http://ecdc.europa.eu/en/publications/Publications/1206-ECDC-MDR-gonorrhoea-response-plan.pdf
- World Health Organization (WHO). Global action plan to control the spread and impact of anti-microbial resistance in Neisseria gonorrhoeae. Geneva: WHO; 2012. Available from: http://whqlibdoc.who.int/publications/2012/9789241503501_eng.pdf
- European Centre for Disease Prevention and Control (ECDC). Gonococcal antimicrobial surveillance in Europe, 2010. Stockholm: ECDC; May 2012. Available from: http://ecdc.europa.eu/en/publications/Publications/1206-Gonococcal-AMR.pdf
- European Centre for Disease prevention and Control (ECDC). Sexually transmitted infections in Europe 1990–2010. Stockholm: ECDC; Jun 2012. Available from: http://www.ecdc.europa.eu/en/publications/Publications/201206-Sexually-Transmitted-Infections-Europe-2010.pdf