Antimicrobial resistance remains an important consideration in the treatment of gonorrhea. With the decreasing use of culture to diagnose gonorrhea, the gonococcal isolate surveillance project (GISP), a sentinel surveillance system that monitors antimicrobial susceptibilities of N. gonorrhoeae, has become an increasingly important source of information. Most recently, data from GISP on quinolone resistant N. gonorrhoeae has resulted in a revision of CDC's treatment guidelines for gonorrhea. With only one class of drugs still recommended for the treatment of N. gonorrhoeae, efforts to monitor the emergence of cephalosporin resistance are critical.