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Diagnosis and management of gonorrhoea in primary care

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Gonorrhoea raises increasing problems with antibiotic resistance making treatment and prevention a concern

Nurses working in primary care settings will likely meet people either at risk of or presenting with suspected or confirmed sexually transmitted infections, including gonorrhoea. As such they are ideally placed to offer screening, advice and onward referral to specialist care. Gonorrhoea has appeared prominently in recent professional and media reports, due to increasing problems with antibiotic resistance making treatment and prevention of infection a concern.1

The British Association of Sexual Health and HIV (BASHH)2,3 and Royal College of General Practitioners4 strongly recommend referring anyone with symptoms suggestive of a sexually acquired infection to a genitourinary medicine (GUM) clinic or other local specialist sexual health service. However in circumstances where services cannot be accessed within a reasonable time, or if the person is unwilling to attend, the person can be managed in primary care – if the appropriate expertise is available.

What is gonorrhoea?

Gonorrhoea is a sexually transmitted infection (STI) caused by the gram-negative diplococci bacteria Neisseria gonorrhoeae. Gonorrhoea represented 7% of newly diagnosed STIs in GUM clinics in 2013, on a par with genital herpes and genital warts.5 There were 44,676 diagnoses of gonorrhoea reported in 2017, a 22% increase relative to the year prior.

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