**1.4 Treatment of** *gonorrhea*

The empiric treatment of gonococcal infection recommended by the WHO was dual therapy (injectable ceftriaxone and azithromycin). However, some countries have transitioned to ceftriaxone monotherapy (increasing dose from 250 to 500 mg intramuscular injection). This is due to the increasing emergence of azithromycin

resistance and the treatment failure of dual therapy as it was reported in 2014 and 2018 in the United Kingdom (UK). This therapeutic strategy has been adapted by other countries, such as the UK, China, and Japan.

Pharyngeal infections are one of the typical treatment failure consequences as they are an important site of infection. Although they are predominantly asymptomatic. This is a warning that the era of untreatable gonorrhea is near, but new drugs that specifically target antibiotic-resistant *N. gonorrhoeae* is under current investigation. Currently, several promising agents are on the horizon for *N. gonorrhoeae*, including new antibiotics. Some new antibiotics target the GyrB subunit in DNA gyrase, such as zoliflodacin, and other target the topoisomerase IV, like the gepotidacin [14].
