What’s new

Ciprofloxacin use now restricted due to MHRA guidance – discuss with a senior clinician prior to prescribing.

Genotypic ciprofloxacin resistance testing is available in some boards to help antibiotic choice but ciprofloxacin should only be used when other antibiotics are inappropriate and after full discussion with the patient about potential disabling, irreversible side effects (refer to local guidance).

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.