Management of urogenital gonococcal infection

Gonorrhoea, caused by the bacterium Neisseria gonorrhoeae , is the second most common bacterial sexually transmitted infection diagnosed in the UK. Diagnoses remain highest among specific population groups: men who have sex with men, young people aged 15–24 years, and individuals of black Caribbean and mixed ethnicities. While most infections are asymptomatic, gonococcal infection can cause painful urogenital symptoms and, left untreated, can result in complications including pelvic inflammatory disease, epididymo-orchitis and infertility. Although infections can be treated successfully, there has been a concerning rise in diagnoses of antibiotic-resistant gonorrhoea in recent times. Treatment options are limited due to antimicrobial resistance and a lack of newer treatment options available. Sexual contacts should be treated if they test positive. Ceftriaxone remains a safe, effective first-line treatment. Ceftriaxone-resistant cases are being detected more frequently although numbers remain low in England and Wales. The recent roll-out of the world’s first vaccination programme to protect against gonorrhoea infection is anticipated to save the NHS millions of pounds over the next decade. It remains to be seen whether this measure will effectively curb escalating national infection rates.