Neisseria gonorrhoeae is a common causative microorganism of male urethritis. The most important
problem with this infectious disease is antibiotic resistance. For instance, in the 1980’s-1990’s,
most studies showed almost 100 % susceptibility of N. gonorrhoeae to the representative cephalosporins,
cefixime and cefpodoxime. By the late 1990s, the reported susceptibility decreased to 93.3-100 % and
further decreased to 82.9-100 % in the early 2000’s. However, reported susceptibility was revived to
95.8-100 % in the late 2000’s to 2010’s. The susceptibility of N. gonorrhoeae to penicillins varied in different
countries and regions. A 2002 Japanese study showed a resistance ratio of about 30% and while
Laos, China and Korea showed 80-100 % resistance. Fluoroquinolones have shown a dramatic change in their effect on N.
gonorrhoeae. In the early 1990’s, 0.3-1.3 % of N. gonorrhoeae showed low susceptibility or resistance to ciprofloxacin in the
US but this figure jumped to 9.5 % by 1999. In Asia, N. gonorrhoeae ciprofloxacin resistance or lower susceptibility was
about 80-90 % in the early 2000’s and this trend continues to the present day. Azithromycin is currently the possible last
weapon for N. gonorrhoeae treatment per oral administration. The susceptibility of N. gonorrhoeae to azithromycin was 100
% in Indonesia in 2004 and the latest study from Germany showed 6 % resistance in strains from 2010-2011. This review
summarizes the history and epidemiology of N. gonorrhoeae antibiotic susceptibilities, for which the most frequently used
antibiotics vary between countries or regions.