Transmission

• contact with genital secretions

• same locations as chlymdia

• incubation \~2-5d (2-10d)

• swabs more accurate if 5-7d after exposure

• vertical transmission

• eye disease more severe in new born

Symptoms

• dysuria, vaginal discharge, lower abdo pain, urethral discharge

• asyumptomatic \~50% women

• \~5% M

Testing:

• FPU

• self swab/endocervical

• transported to laboratory ASAP

• ???up to 50% loss of viable organism???

-

First line:

• Ceftriaxone 500mg IM stat

  • make up with 2mL lignogaine 1%

• plus

• azithromycin 1g stat

• coinfection with chlaymidia is very common

• if isolate known to be ciprofloxacin stansitive 500mg stat dose of ciprofloxacin can be used

• test of cure not usually required

  • risk of re-exposure

  • symptoms do not resovle

  • non-standard medicien

    • five weeks

• no unprotected sex for 1wk post treatment

Ceftriaxone used if antibiotic susceptibility unknown, if cipro resistant, women who are pregnant or BF

increase in dose = overocme cephalosporin resistnace in N.gonorrhoea

prevalence of ciprofloxacin resistance high as 54% in some areas of NZ