Gonococcal urethritis is caused by Neisseria gonorrhoeae, which is transmitted through sexual contact and vertically. Gonorrhea remains a major public health problem. Gonorrhea manifests in men as acute anterior urethritis with dysuria and profuse and purulent discharge. The diagnosis of gonococcal infection is based on the identification of the microorganism in secretions from infected sites using Gram stain, culture, and/or molecular biology techniques. No test offers 100 % sensitivity and specificity.
Neisseria gonorrhoeae has developed resistance to multiple classes of antibiotics, and recently resistance and even clinical failures to ceftriaxone and cefixime have been confirmed. According to the European guidelines for the diagnosis and treatment of gonorrhea in adults, uncomplicated gonococcal urethritis should be treated with ceftriaxone 500 mg intramuscularly (IM) as a single dose together with azithromycin 2 g as a single oral dose. Sexual partners in the preceding 60 days should be treated as well, and a test of cure is recommended in all cases. Treatment failures and resistant strains should be reported to health authorities.
KeywordsGonorrhea Neisseria gonorrhoeae Gonococcal urethritis Cephalosporins Treatment failure Resistance
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