The aim of this study is to identify the demographic and diagnostic characteristics of patients attending a genitourinary medicine clinic with booked appointments and compare them with those of walk-in attendees. During a period of three months, 749 patients were seen with new episodes; 61% of them had booked appointments; 50.6% of walk-in attendees had symptoms compared with 40.6% in the appointment category; 58.6% of walk-in attendees gave specific reasons for attendance other than asymptomatic requests for sexual health assessment and tests, compared with 48.1% in the appointment category. It is more likely that students and individuals in employment to attend with appointments. The majority of individuals made the right decision for themselves whether to book appointments or just walk-in. The rates of non-D3 codes and sexually transmitted infections in the two groups were not statistically different.

The management outcome of gonorrhoea in the northern region of England was assessed and compared with the recently published national guidelines. An audit questionnaire was completed by all genitourinary medicine (GUM) clinics in the region. Information with regard to demographic data, microscopy, culture results, test of cure, antibiotic use and sensitivity and contact tracing were recorded. A total of 420 cases of gonorrhoea were diagnosed in 1998. The ratio of males to females with gonorrhoea was 2.1:1. Half were heterosexual males and one-third females. Direct microscopy was positive in 85% of heterosexual males but in less than one-third of females. Ciprofloxacin was the most commonly used antibiotic. One-third of the isolates were resistant or partially resistant to penicillin. Health advisors saw 85% of patients and 41-68% of 'potential' contacts were seen. The management of gonorrhoea in the northern region of England complies with the national guideline recommendations.

Greater awareness of the risk of malaria by travelers and medical practitioners in UK must be encouraged and in particular appropriate chemoprophylaxis instituted for travelers to chloroquine-resistant areas.

No abstract

Neisseria gonorrhoeae isolates that were resistant to ciprofloxacin and/or penicillin were analysed to investigate the escalating problem of antibiotic-resistant gonorrhoea in the north east of England. Opa-typing (outer membrane opacity protein) was carried out on isolates resistant to ciprofloxacin and of nutrient nonrequiring (NR) auxotype. In the year 2000 there were 265 cases of gonorrhoea, of which 44 (16.6%) were resistant to penicillin and 12 (4.5%) were resistant or had reduced sensitivity to ciprofloxacin (with only four of these acquired outside the UK). Three (7.5%) of the non-beta-lactamase penicillin-resistant isolates were imported from abroad. By Opa-typing of ciprofloxacin-resistant strains, one pair of the isolates was similar, two were unique and one was similar to the Oldham/Rochdale outbreak strain described early in 2000. This marked increase in the prevalence of indigenous ciprofloxacin resistance requires continued surveillance and may soon necessitate an alteration in our first line treatment.