Test of cure is recommended 2-3 weeks post completion of treatment and is particularly important where sensitivities are unknown and/or ceftriaxone treatment not given.Treatment can be initiated, as outlined in the table below, without sensitivity results. NAAT testing does not currently give information on gonorrhoea antimicrobial susceptibility and wherever possible culture and sensitivity testing needs to be done.Empiric treatment with oral cefixime or ciprofloxacin is inappropriate.Increasing resistance to antimicrobials is a major concern with gonorrhoea globally. Ciprofloxacin resistance was seen in 45% of isolates tested in the national Gonococcal Reference Laboratory in 2019.A diagnosis of gonorrhoea in MSM should prompt a discussion about HIV prevention including PrEP.In sexually active men who have sex with men (MSM), pharyngeal and rectal sites should be tested too.Vulvovaginal swabs can be provider or self-taken. Diagnosis can be made on first void urine in males and vulvovaginal or endocervical swab in females.This is frequently combined with a chlamydia NAAT in the same test. PCR, polymerase chain reaction) is the current diagnostic gold standard. Diagnosis using NAAT (nucleic acid amplification technique, e.g.PID is associated with an increased risk of tubal factor infertility, ectopic pregnancy and chronic pelvic pain. Infection can lead to pelvic inflammatory disease (PID) in females.Infection can lead to epididymo-orchitis in males.Symptoms in women include vaginal discharge, intermenstrual bleeding, post coital bleeding. Symptoms in males include dysuria and a urethral discharge. Infection can be asymptomatic in both males and females.The number of cases of gonorrhoea reported in Ireland has been increasing in the recent past and the increase appears to be occurring in young heterosexual men and women and men who have sex with men (MSM).Patients who are allergic to cephalosporins should be referred to a dedicated service and where not possible, discussed with a specialist in Genitourinary Medicine or Infectious Diseases. Consideration should be given to referring patients with suspected gonorrhoea to a dedicated GUM clinic.Dermatophyte Infection Fingernail or Toenail.Recurrent Cellulitis and Leg Ulcers - Antibiotic Prescribing.Hidradenitis Suppurativa - Antibiotic Prescribing.Animal and Human Bite - Antibiotic Prescribing.Approach to an STI consultation in Primary Care.Recurrent UTI in Adult, Non-Pregnant Females.UTI in Long Term Care Residents 65 years.Position Statements Dipstick Urinalysis for UTIs in Adults.Prescribing Antimicrobials in Pregnancy and Lactation.Azithromycin Prophylaxis in Adults with Respiratory Disease.COVID -19 Acute Respiratory Infection (Adults).Community Acquired Pneumonia in Children.Pneumonia and Aspiration Pneumonia in Nursing Homes/Residential Care Facilities.

Long term gonorrhea symptoms