What’s new

Dose of IM Ceftriaxone has now been increased to 1g
Oral ciprofloxacin is now the antibiotic of choice where susceptibility predicted and there are no contraindications – not all Boards have access to Speedx ResistancePlus GC assay
An appendix on the preparation of parenteral antibiotics has been added
An appendix on managing presentations of Neisseria meningitidis has been added

Introduction

Gonorrhoea is the clinical disease resulting from infection with the Gram negative diplococcus Neisseria gonorrhoeae.
Primary sites of infection are the mucous membranes of urethra, endocervix, rectum, pharynx and conjunctiva.
50% of females with endocervical infection and 10% of males with urethral infection will be asymptomatic.
The majority of pharyngeal infections in both sexes are asymptomatic. Rectal infections may cause symptoms but are generally asymptomatic. In females, rectal infection can be due to transmucosal spread rather than anal intercourse.