Gonorrhea is the second most commonly reported communicable disease in the US, and the number of cases is increasing annually.[3] Between 2013 and 2017, there was a 67% increase in reported gonorrhea cases.[3] In 2017, the gonorrhea rate in the US was 171.9 cases per 100,000.[3] The lowest rate of gonorrhea in the US was recorded in 2009 (98.1 cases per 100,000); since then gonorrhea rates have had sustained increases.[3] The southern US continues to have the highest rates in the country. Rates continue to be highest among certain groups, such as men who have sex with men, and black people. Rates also continue to be higher in men than in women. The highest rates in women are seen in the 15 to 24 years age group. The highest rates in men are seen in the 20 to 29 years age group.

High rates of antimicrobial resistance to penicillin, tetracycline, and quinolones have been reported from the Gonococcal Isolate Surveillance Project (GISP), and there is concern about the potential of reduced susceptibility to extended-spectrum cephalosporins and macrolides.[4] Rare isolates have also been found with reduced susceptibility to cephalosporins and azithromycin, which has led to increased vigilance for antimicrobial resistance and updated treatment guidance.

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