Management of gonorrhoea: are we meeting national standards?

• Published in: International journal of STD & AIDS 2004-05, Vol.15, p.28
• Main Authors: Fernandes, A, Clarke, M, Dean, M, Sheere, S
• Format: Article
• Language: English
• Subjects: Chlamydia trachomatis; Neisseria gonorrhoeae
• ISSN: 0956-4624; 1758-1052

To assess whether clients diagnosed with gonorrhoea were managed according to national standards. An audit of all clients diagnosed with gonorrhoea at a busy Genitourinary Department over consecutive 3-month periods in 2000 was conducted, changes implemented, and the cycle completed by re-auditing during the same period in 2002. The information collected was reviewed in light of national recommended standards. Sixty-six cases of gonorrhoea were diagnosed in 2000, and 114 in 2002. In 2000, 98% (40) of male urethral gonorrhoea and 40% (8) of female cervical/urethral gonorrhoea was diagnosed on microscopy, compared with 93% (82) and 32% (7) respectively for 2002. All patients were screened for Chlamydia trachomatis in 2000 and 113 (99.1%) in 2002. Fifty-nine (89%) received presumptive treatment for C. trachomatis in 2000. In 2002, all patients received such treatment (P < 0.001). Fifty-six (85%) patients had contacts discussed at their initial visit in 2000 and 103 (90%) in 2002. Forty-one (62.1%) patients returned for at least one follow-up visit in 2000, compared with 65 (57%) in 2002. Figures were higher for women in both reviews. In 2000, for patients who returned for test of cure, 18 of 22 (81%) males and 14 of 15 (93%) females were cured by first-line therapy. Comparable figures for 2002 were 44 of 49 (90%) males and 15 of 16 (94%) females. A sharp rise in the number of patients diagnosed with gonorrhoea was noted over the 2-year period between reviews. Management of patients was in keeping with the recommended national standards and there was evidence that, as a result of this audit, clinical care improved.