2012 European guideline on the diagnosis and treatment of gonorrhoea in adults

Abstract

Gonorrhoea is a major public health concern globally. Of particularly grave concern is that resistance to the extended-spectrum cephalosporins has emerged during the most recent years. This guideline provides recommendations regarding the diagnosis and treatment of gonorrhoea in Europe. Compared to the outdated 2009 European gonorrhoea guideline, this 2012 European gonorrhoea guideline provides up-to-date guidance on, broader indications for testing and treatment of gonorrhoea; the introduction of dual antimicrobial therapy (ceftriaxone 500 mg and azithromycin 2 g) for uncomplicated gonorrhoea when the antimicrobial sensitivity is unknown; recommendation of test of cure in all gonorrhoea cases to ensure eradication of infection and identify emerging resistance; and recommendations to identify, verify and report failures with recommended treatment regimens. Optimisations of the testing, diagnostics, antimicrobial treatment and follow-up of gonorrhoea patients are crucial in controlling the emergent spread of cephalosporin-resistant and multidrug-resistant gonorrhoea.

Gonorrhoea in Greenland: geographic differences in diagnostic activity and incidence of gonorrhoea in 2015

“…Since 2009 the number of gonorrhoea cases has exceeded 1,000 per year [9,18]. We have observed an overall increase in gonorrhoea cases in 2015, however there may be even more cases of gonorrhoea than reported, since the infection can be asymptomatic in women ( 50 %) and in cases of urethral infections asymptomatic in men ( 10 %) [24].…”

“…All patients with positive gonorrhoea tests are offered a combination treatment of 500 mg ceftriaxone i.m. and azithromycin 2 g according to European guidelines [10,17,18]. …”

Die deutsche Laborlandschaft zu Diagnostik und Antibiotikaresistenztestung bei Neisseria gonorrhoeae

“…In den letzten Jahren galten Breitspektrum-Cephalosporine der dritten Generation als letzte Mittel in der Behandlung einer NGInfektion [14,15]. In jüngster Zeit wurden in Japan, Australien, Kanada, Südafrika und in einigen europäischen Ländern wie England, Frankreich, Spanien, Österreich und Schweden zunehmende Resistenzentwicklungen gegen Cefixim beobachtet [11,[16][17][18][19][20][21][22][23].…”

“…Qualitativ und quantitativ hochwertige SurveillanceProgramme zu Antibiotikaresistenzen bei NG, beispielsweise mittels einheitlicher Resistenztestungsmethoden und Ablesestandards sowie repräsentativer Abdeckung der erhobenen Daten, sind daher von hoher Public-Health-Relevanz [14,20] und sollten die von den Laboren jeweils unterschiedlich angewendeten Diagnostikmethoden beachten [37,38].…”

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“…Since 2010, cefixime is no longer recommended as first-line treatment [5] following guidelines from the World Health Organization (WHO) that an antibiotic should not be used when more than 5% of N. gonorrhoeae isolates are resistant [6]. Injectable ceftriaxone, in combination with oral azithromycin, is now the last antibiotic remaining as recommended firstline treatment [7]. Although other antibiotics are being tested for their safety and efficacy for N. gonorrhoeae treatment [8], no new classes of antibiotics are currently available [4] and management of antibiotics is urgently needed to preserve their efficacy.…”