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

Comparison of two Gram stain point-of-care systems for urogenital gonorrhoea among high-risk patients: diagnostic accuracy and cost-effectiveness before and after changing the screening algorithm at an STI clinic in Amsterdam

“…The NPV is high, despite a low sensitivity, because of the low prevalence of gonorrhoea among high-risk female patients. The low sensitivity of Gram stain microscopy in women in our study confirms the results of earlier studies 9 10. Nonetheless, because of the presence of other infections such as candidiasis, trichomoniasis and bacterial vaginosis, we continue to offer a Gram stain to symptomatic high-risk women.…”

Molecular epidemiology and mechanisms of resistance of azithromycin-resistantNeisseria gonorrhoeaeisolated in France during 2013–14

“…2 -4 Consequently, a dual antimicrobial treatment with a single dose of ceftriaxone (500 mg intramuscularly) and azithromycin (2 g orally) has been recently recommended in Europe. 5 Since the end of 2015, spectinomycin is no longer available in France and without cephalosporin, no other main treatment options are available.…”

Verified clinical failure with cefotaxime 1g for treatment of gonorrhoea in the Netherlands: a case report

“…Due to the shorter half-life of cefotaxime of 1.3 h in comparison with ceftriaxone (7 h) after intramuscular injection, in combination with differences in protein binding, the time of unbound antibiotic over MIC of this strain will be 7.8 h after injection of 1g cefotaxime intramuscularly, but 35 h after 500 mg ceftriaxone intramuscularly 7 8. Accordingly, cefotaxime is no longer recommended for empiric treatment of NG in the Dutch GP guidelines and instead ceftriaxone is now recommended, which is in accordance with treatment guidelines for NG 9. In the Netherlands, ceftriaxone replaced cefotaxime in the Public Health treatment guidelines in 2007; however, the guidelines for Dutch GPs did not implement this replacement until 2013.…”