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Globally, bacterial sexually transmitted infections (STIs) are a major health challenge. It is more challenging in resource-limited settings, where diagnostic capabilities are limited, health insurance is almost nonexistent and medical bills are settled out-of-pocket. In resource-limited settings, most clinicians adopt the syndromic case management approach for effective treatment due to the paucity of resources. The highest levels of multidrug resistant bacterial STIs have been found in resource-limited countries. The reasons are complex and include poor quality of health services, high burden of disease, lack of accessible, accurate, and confirmed diagnostic assays, ineffective regulations, overuse of antibiotics, inappropriate dosing, and lack of knowledge about the risks of microbial resistance. This chapter thus brings to the fore the challenges of treating bacterial sexually transmitted infections in resource-poor settings and the current evidence on the topic for scholars, researchers, and practitioners.

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