Two stories are unfolding in sexual health right now, and they point in opposite directions. Globally, the bacteria behind common STDs are becoming harder to treat — drug-resistant gonorrhea in particular has public health agencies genuinely concerned. Yet here in California, years of prevention work are paying off with declining infection rates. Both halves of that story matter for how you should think about testing and treatment in 2026.
The resistance problem: gonorrhea is learning to beat our antibiotics
Gonorrhea has outmaneuvered nearly every antibiotic ever thrown at it — penicillin, tetracyclines, fluoroquinolones — and today a single injection of ceftriaxone is the last remaining first-line therapy. That is why the newest surveillance numbers deserve attention. Global monitoring reported by the WHO shows resistance climbing fast in just two years:
- Ceftriaxone resistance: 0.8% of samples in 2022 → 5% in 2024
- Cefixime (the oral backup): 1.7% → 11%
- Azithromycin: 0.5% → 4%
In 2026 the CDC’s Emerging Infectious Diseases journal documented the spread of ceftriaxone-resistant strains carrying the penA-60 gene across the Asia-Pacific region — and warned that because only a handful of countries run comprehensive resistance surveillance, the true prevalence is likely underreported. Resistant strains travel with people; "elsewhere" has a way of becoming "here." Encouragingly, two new antibiotics developed specifically for gonorrhea (gepotidacin and zoliflodacin) are arriving — but the clinical lesson today is simple: gonorrhea should be treated with the right drug, at the right dose, with follow-up — not with leftover antibiotics or guesswork.
Resistance isn’t just gonorrhea
Mycoplasma genitalium — a lesser-known cause of persistent urethritis and pelvic symptoms — now shows high rates of resistance to azithromycin, the antibiotic most often used empirically for "non-specific" symptoms. This is exactly why we added Mycoplasma and Ureaplasma testing to our panel: identifying the actual organism is what lets treatment be chosen correctly the first time, instead of burning through antibiotics that quietly breed more resistance.
The numbers: nation vs. California
Nationally, the syphilis epidemic remains the sobering headline of recent surveillance — U.S. maternal syphilis rose 28% between 2022 and 2024, part of a decade-long climb that has brought congenital syphilis back to levels not seen in a generation.
California, however, is finally bending the curve. The California Department of Public Health reports that STIs declined for a third consecutive year through 2024 — chlamydia, gonorrhea, syphilis, and congenital syphilis all down — and while national maternal syphilis rose 28%, California’s fell 19% over the same period. Credit belongs to expanded screening (including prenatal testing), prevention tools like doxy-PEP reaching more patients, and easier access to testing.
Before anyone relaxes: the burden remains enormous. Los Angeles County alone reported nearly 90,000 STI cases in 2023 — roughly 60% chlamydia, 29% gonorrhea, and 11% syphilis — after a decade of rising rates. "Improving" and "low" are very different things, and most infections still spread through people who have no symptoms at all.
What this means for you, practically
- Test — don’t guess. Most chlamydia and gonorrhea infections are silent. Routine screening with any new partner, or at least annually if you’re sexually active with more than one partner, is the standard of care.
- Persistent symptoms after treatment deserve a second look — possible resistance, reinfection, or an organism the first panel didn’t cover (this is where Mycoplasma/Ureaplasma testing earns its keep).
- Complete the exact treatment prescribed, and loop back for follow-up testing when we recommend it — especially for gonorrhea, where confirming cure now matters more than ever.
- Partners need treatment too — otherwise the infection simply ping-pongs back.
- Had a possible HIV exposure? Post-exposure prophylaxis (PEP) must start within 72 hours — come in immediately. (We offer HIV testing and PEP; ongoing HIV care is referred to specialists.)
Confidential, same-day, no appointment
Our STD testing and treatment service is private and judgment-free, with an on-site laboratory for same-day collection — urine, blood, or swab as appropriate — and treatment started promptly when something is found. Many patients from Alhambra, South Pasadena, and Eagle Rock choose us precisely because we’re a discreet clinic outside their immediate neighborhood. Walk in Monday–Friday 8 AM–8 PM or weekends 9 AM–5 PM (last patient 30 minutes prior to close), or call (626) 304-0404.
Sources: WHO Enhanced Gonococcal Antimicrobial Surveillance Programme via CIDRAP (2026); CDC Emerging Infectious Diseases, June 2026 (penA-60 ceftriaxone-resistant N. gonorrhoeae; global surveillance limitations); California Department of Public Health STI surveillance (2024 data, released 2025–26); Los Angeles County DPH STI Snapshot 2023.