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Gonorrhoea - Management
Basis for recommendation
Recommendations on follow up are based on the National guideline on the diagnosis and treatment of gonorrhoea in adults, published by the British Association for Sexual Health and HIV [BASHH, 2005b], a primary care guideline [RCGP and BASHH, 2006], and a European guideline [Bignell, 2009].
- Anogenital gonorrhoea usually responds well to antibiotics to which it is known to be sensitive, and test of cure is not necessary unless symptoms persist.
- CKS recommends a routine test of cure for pregnant women, as the infection can have serious consequences for the mother and baby if it persists (including spontaneous abortion, premature labour, early rupture of fetal membranes, perinatal mortality, and gonococcal conjunctivitis in the newborn) [Handsfield and Sparling, 2005].
- Pharyngeal gonorrhoea responds less well than anogenital gonorrhoea to treatment with antibiotics [Moran and Levine, 1995] and may cause no symptoms. Therefore, a test of cure is reasonable.
- Swabbing for culture is recommended, as this allows sensitivity testing (which should be done at least 3 days after antibiotic treatment to avoid false-positive results). Nucleic acid amplification tests do not provide information on sensitivity and require a longer washout period [BASHH, 2005b].
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