What is included in monitoring following treatment for gonorrhea?

Updated: Sep 07, 2018
  • Author: Brian Wong, MD; Chief Editor: Pranatharthi Haran Chandrasekar, MBBS, MD  more...
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Answer

Per the 2015 CDC Sexually Transmitted Diseases Treatment Guidelines, a test-of-cure is no longer needed for patients with uncomplicated urogenital or rectal gonorrhea who are treated with recommended or alternative regimens.

However, patients with pharyngeal gonorrhea treated with an alternative regimen should be rested for 14 days after treatment and be tested for cure with NAAT assay or culture. Confirmatory testing of the repeat NAAT assays that are positive and further antimicrobial susceptibility testing may be needed.

In many cases, "treatment failure" may result from reinfection from sexual partners who have not received appropriate therapy.

Reevaluation 3 months after treatment is recommended by the CDC. This is distinct and different from immediate test of cure. If 3-month retesting is not possible, the patient should undergo repeat screening at the next medical encounter, within 12 months of treatment.

Instruct patients with uncomplicated gonococcal infections to follow up with a primary care physician or public health provider to reduce the risk of future infection.

Early follow-up care and culture with antibiotic sensitivities are indicated in patients with unresolved or recurrent symptoms despite therapy.

Patients with disseminated gonococcal infection (DGI) or pelvic inflammatory disease (PID) who are treated in an outpatient setting must receive follow-up care within 24 hours.


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