Follow up and test of cure

Follow-up after treatment is recommended to (1):

• check treatment compliance
• check whether symptoms have resolved
• check for any adverse reactions
• assess the risk of re-infection
• to organise or check the progress of contact notification and provide health education

A test of cure (TOC) is recommended in all cases due to emerging resistant. In instances where TOC is required to be selective rather than universal, the following patients should be prioritized:

• persisting symptoms or signs
• pharyngeal infection (all treatments are less effective at eradicating pharyngeal infection)
• treatment with anything other than the first-line recommendations (1)

If a test of cure is performed, the method and timing is arbitrary

• persisting symptoms or signs – test with culture, performed at least 72 hours after completion of therapy
• if asymptomatic – test with NAATs where available, followed by culture if NAAT-positive. Test two weeks after completion of antibiotic therapy (1)

Note that infection identified after treatment may well be due to reinfection (1).

Reference:

• (1) Bignell C, Fitzgerald M; Guideline Development Group.UK national guideline for the management of gonorrhoea in adults, 2011. Int J STD AIDS. 2011;22(10):541-7.