Sexually Transmitted Infections & Antibiotic Resistance: What You Need to Know

Written By Niyati Pandya - March 05, 2025

Read Time - 3 min read

Did you know? India was among the top two countries that recorded the highest number of STI cases in 2019! Fortunately, some of the bacterial STIs such as chlamydia and gonorrhoea, if diagnosed early, can be effectively treated. However, a growing concern is the emergence of antibiotic resistance in sexually transmitted infections in various parts of the world. This situation highlights the need for vigilant diagnosis and treatment.

Let us delve deeper into the problem of antibiotic resistance in STIs, understand its consequences and look at the ways to deal with it. Let’s begin.

What Is Antibiotic Resistance?

Antibiotics are medicines prescribed to treat bacterial infections. When used correctly, these medicines help patients recover from STIs. However, the WHO has observed a rising problem of antibiotic resistance. It’s a phenomenon where the bacteria develops the capability to adapt or change itself in ways that can resist the effects of an antibiotic.

These resistant bacteria can multiply over time, resulting in severe complications for the patients. The consequences of antibiotic resistance in STIs include amplified treatment costs, extended hospital stays, and higher mortality rates. It poses an urgent public health threat, especially when we observe 550,000 drug-resistant cases of STIs like Neisseria gonorrhoeae every year.

Why Is Antibiotic Resistance In STIs A Concern?

When it comes to bacteria-related sexually transmitted infections, WHO estimates revealed 129 million cases of Chlamydia and 89 million cases of Gonorrhoea across the globe in 2020. While the quick transmission is a concern in itself, antibiotic resistance in STIs adds another layer of trouble while trying to combat this serious infection.

Chlamydia, gonorrhoea, and syphilis are severe public health concerns in the present scenario. They affect the quality of life of millions worldwide, causing serious illnesses and, in some cases, death. Therefore, WHO has modified and released new guidelines. These guidelines emphasise the importance of treating bacterial STIs with appropriate antibiotics, in the prescribed dose, and at the proper time to minimise their spread. Despite these measures, certain bacterial strains are swiftly adapting and demonstrating antibiotic resistance.

How Does Antibiotic Resistance Happen?

While antimicrobial resistance (AMR) is a natural process in bacteria, antibiotic use makes it worse. Bacteria can become resistant to antibiotics when they:

Turn on certain internal resistance processes
Change to protect themselves from an antibiotic
Receive resistant genes from another bacteria.

Who Is At Risk From Antibiotic-Resistant STIs?

Anyone who is sexually active can be at risk of contracting antibiotic-resistant STIs. However, you may be more vulnerable if -

Have weakened immune systems due to illness or as a side effect of treatment for their condition.
Practice unprotected sex or have multiple partners.
Inject drugs or those who have a history of STIs may develop ongoing or repeated antibiotic-resistant STIs.

Symptoms Of Antibiotic-Resistant STIs

Pain when urinating
Unusual discharge from the vagina, penis or anus
Itching around the genitals or anus
Pain during sexual intercourse

Can These STIs Be Treated?

Gonorrhoea is commonly treated with a single injection of ceftriaxone, an antibiotic given into the thigh or buttock muscle. This method is known as an intramuscular injection. Knowing how sensitive the bacteria are to the antibiotic, beforehand, can be helpful. This involves testing to find out which drug will best treat the infection.

Chlamydia is typically treated with a short course of oral antibiotics. If these medications cause discomfort or hard-to-tolerate side effects, your doctor might prescribe a different set of antibiotics for a longer duration.

What Types Of Antibiotic-Resistant Bacteria Are The Most Dangerous?

The deadliest antibiotic-resistant bacteria include those linked to the highest number of deaths from infections worldwide. They are:

Escherichia coli (E. coli).
Staphylococcus aureus (S. aureus).
Klebsiella pneumoniae (K. pneumoniae).
Streptococcus pneumonia (S. pneumoniae).
Acinetobacter baumannii (A. baumannii).
Pseudomonas aeruginosa (P. aeruginosa).

How Does Antibiotic Resistance Impact STI Treatment?

The rise of antibiotic resistance in STIs is dramatically narrowing the treatment options.5 Healthcare providers have to keep updating their treatment methods in accordance with the new guidelines considering the increasing antibiotic resistance.

Patients who do not respond well to their first round of treatment are now screened to rule out multidrug-resistant STIs. A negative response during these tests can help determine if the prescribed treatment or drug has shown some effect against the infection.

Multidrug-resistant STIs are identified through antibiotic sensitivity testing, which requires an individual to collect vaginal or urethral swab samples and send them to a lab for culture (growing and identifying the bacteria in lab). The culture results and antibiotic sensitivity tests guide future drug treatments.

How Can We Fight Antibiotic Resistance?

Below are some tips that may help combat antibiotic resistance.

Ensure hygiene, always- Protect yourself from infection and help combat antibiotic resistance. Handwashing is key.
Take antibiotics only when necessary; don't assume you need them. They don’t work on viral infections. So, get a proper diagnosis and treatment plan from your healthcare provider.
Get the vaccinations recommended by your doctor - Most antibiotic-resistant bacteria don't have vaccines. However, the vaccine for pneumococcal disease also protects against S. pneumoniae infections.

What Can Be Done To Address The Problem?

Here are some potential strategies to address antibiotic-resistant STIs:

Control the spread of new infections through prevention, screening, and treatment.
Develop new antibiotics.
Develop tests to identify the best treatments.

Wrapping Up

In conclusion, the rise of antibiotic resistance in STIs is a serious threat to public health. As antibiotic resistance continues to spread, we must adopt a multi-faceted approach to combat this growing threat. By promoting safe sex practices, improving access to STI testing and treatment, and investing in research and development, we can work towards reducing the after-effects of antibiotic-resistant STIs.