| A quick update on gonorrhoea
There has been a significant increase in the incidence of gonorrhoea in NSW over the last 12 months. Most of the increase has been noted in gay men from inner city areas of Sydney. To date the NRAHS has been notified of 10 cases of gonorrhoea this year. Last year a total of nine notifications were received. Because of high mobility of many gay men we may expect to see an increased incidence locally (as has happened in the past with hepatitis A following outbreaks in sexually active gay men in Sydney).
Ceftriaxone 250mg I.M.I. remains the treatment for all uncomplicated urethral, endocervical, anal and pharngeal gonorrhoea. Unfortunately there are currently no oral third generation cepholosporins available for use in Australia. Penicillin (including Amoxycillin) and non third generation cepholosporins will fail in the large number of cases where a penicillin resistant organism is involved. The incidence of quinalone resistance is also high and precludes their use and spectinomcyin may not adequately treat pharngeal gonorrhoea as a stat injection.
Kieran Mutimer is a venereologist and is the medical director of SHAIDS in Lismore.
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