“The rapid adaptation in our provision of clinical sexual health care during the COVID-19 pandemic has required minimisation of face-to-face consultations and the development of safe but effective means of treating individuals with diagnosed infections. The “new normal” chlamydia treatment pathway has been via postal delivery of oral antibiotics for many patients*, but for those diagnosed with gonorrhoea their care has still usually required clinic attendance for culture testing and IMI [intramuscular injection] ceftriaxone. This could be largely avoided with molecular detection of antimicrobial resistance markers in the diagnostic sample and the use of single-dose oral ciprofloxacin where possible. When sensitive strains are detected, this is still a very effective and reliable treatment for gonorrhoea at both genital and extragenital sites that can be prescribed for patient collection or postal treatment. Such testing could not only help achieve reduction in clinic attendances but also avoid the use of suboptimal oral therapies such as cefixime and azithromycin. In the post-COVID era we will continue to rely heavily on online testing via home sampling and assays such as ResistancePlus® GC will be increasingly valuable going forward.”
– Dr. John White, Consultant Physician in Sexual Health/HIV
*patients with symptoms of infection or those with additional care needs might still require in-clinic assessment and further individualised care
1. Jonathan R. et al Accessibility of sexual health services in teenage sexual health service users: local area geospatial analysis, Journal of Public Health, 2012; 34(3): 439-446.
2. Online article (2020) RT News Dec 23. Available at: https://www.rt.com/news/510492-antibiotics-covid-super-gonorrhea/
3. 2018 European Gonococcal Antimicrobial Surveillance Programme Data – Published 2020. Available at: https://www.ecdc.europa.eu/en/publications-data/gonococcal-antimicrobial-susceptibility-surveillance-europe-2018
4. Unemo M. et al. 2020 European guideline for the diagnosis and treatment of gonorrhoea in adults. International Journal of STD & AIDS. October 2020. DOI: 10.1177/0956462420949126
5. Fifer et al. 2018 UK national guideline for the management of infection with Neisseria gonorrhoeae. International Journal of STD & AIDS (2020); 31(1): 4-15.
6. Thomson-Glover R, Hamlett H, Weston D, et al Coronavirus (COVID-19) and young people’s sexual health. Sexually Transmitted Infections (2020); 96:473-474.
7. BASHH/BHIVA News (2018) British Association for Sexual Health and HIV. Oct 5. Available at: https://bashh.org/news/news/government-funding-cuts-leave-sexual-health-and-hiv-care-at-breaking-point/
8. NHS Prescription Services (2021) NHS Business Services Authority. Available at: https://www.nhsbsa.nhs.uk/pharmacies-gp-practices-and-appliance-contractors/drug-tariff
+Price taken from basic price listing from NHS business service authority Drug Tariff March 2021. Cost comparison based on a single 500mg ciprofloxacin pill from pack of 10 vs 1g ceftriaxone powder for injection.
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