What are antibiotic-resistant STIs?

Reviewed by our clinical team

If you’re sexually active and have had unprotected sex, you might have been at risk of catching a sexually transmitted infection (STI) – or at least had a close call!

In the UK and around the world STIs like chlamydia remain pretty common. This is because 1) they spread easily during sex and 2) they don’t always cause symptoms in the early stages, meaning you’re more likely to pass them on to a partner.

The good news is that many common STIs are bacterial, making them easy to treat with a course of antibiotics. The bad news is that certain STI strains are developing a resistance to the standard antibiotic treatment – read on to find out what this means, and how you can stay safe.

What does 'antibiotic resistance' mean?

The first thing to understand is that antibiotics are medication used to prevent or treat bacterial infections. They can’t be used to treat viruses, which is why you won’t be prescribed antibiotics for a cold or the flu (both of which are viral).

The second thing to understand is that bacteria can “learn” to resist the effects of certain antibiotics when they are used too regularly. This means that many standard antibiotics can become ineffective at treating certain bacterial infections. 

Which STIs are becoming antibiotic resistant? 

Gonorrhoea 

In the UK, the main STI which is causing concern about antibiotic resistance is gonorrhoea. This is an STI that can cause unusual discharge from the penis or vagina, pain when urinating and – in women – bleeding between periods.

In December 2021, the UK Health Security Agency (UKHSA) put out a press release about a man in London with a strain of gonorrhoea resistant to the antibiotic ceftriaxone, “the last remaining treatment for gonorrhoea”.

Shigella

Another infection which is associated with antibiotic resistance is shigella. According to UKHSA, cases of antibiotic-resistant shigella rose from 2020 to 2021, going from 16 cases in a 17-month period to 47 cases in just a four-month period.

Shigella is an infection of the intestine that causes stomach cramps and diarrhoea. It’s caused by infected poo getting into the mouth, and can make someone infectious for up to a month. It’s referred to as an STI because it can be passed on during rimming (anal-oral sex) or by giving someone oral sex after they’ve had anal sex. 

What are the causes of antibiotic resistance? 

Antibiotic resistance is caused by the overuse and misuse of antibiotics. This is why the NHS is beginning to limit the use of antibiotics for non-serious infections. 

As an individual, you can help combat antibiotic resistance by: 

• Only using antibiotics when you’ve been prescribed them 
• Taking your antibiotics exactly as directed e.g. not finishing the course early 
• Never sharing antibiotics

You can also protect yourself against infection by: 

• Regularly washing your hands 
• Preparing food hygienically 
• Getting all recommended vaccines 
• Avoiding contact with sick people 
• Practising safe sex

How to protect yourself against antibiotic-resistant STIs

If you’re concerned about coming into contact with an antibiotic-resistant STI, the best thing you can do is practise safe sex.

Gonorrhoea is mainly carried in semen and vaginal fluid and can be passed on during vaginal, anal and oral sex. It can infect and cause symptoms in the cervix, urethra and rectum, and – less commonly – the throat and eyes.

Shigella is carried in poo and can be passed on and cause an infection when poo enters the mouth. This means it’s most likely to spread through rimming and oral sex. 

Safe sex means: 

• Using condoms for penetrative vaginal and anal sex 
• Using condoms and dental dams for oral sex and rimming 
• Not sharing sex toys unless you clean them or cover them in a fresh condom between uses 
• Not sharing douching equipment 
• Wearing gloves for fingering or fisting

Men who have sex with men are also at a higher risk of catching Shigella. Try to always do the following: 

• Wash your hands after sex 
• If you can, have a shower after sex and wash your bottom and genitals 
• Change condoms between anal and oral sex 
• Wear gloves for fingering or fisting

Get tested for STIs with Online Doctor 

If you’re sexually active, it’s a good idea to get tested for STIs every time you change partners – and to ask your partner to do the same. Otherwise, it’s a good idea to get a check-up for STIs once a year, or whenever you develop new symptoms. Lots of STIs don’t initially cause symptoms, which means you might pass one on without ever knowing you’ve had it.

Luckily, testing for STIs is available on the NHS and through private services like Online Doctor. 

References

https://www.who.int/news-room/fact-sheets/detail/antibiotic-resistance
https://www.nhs.uk/conditions/gonorrhoea/
https://www.nhs.uk/live-well/sexual-health/sexual-health-for-gay-and-bisexual-men/
https://www.nhs.uk/conditions/antibiotics/antibiotic-antimicrobial-resistance/