Antimicrobial resistance and/or treatment failure

• Clinicians who detect or suspect a case of gonorrhoea treatment failure are requested to liaise with the local laboratory initially and send specimens to them for culturing of N. gonorrhoeae. Clinicians are also requested to notify their local Department of Public Health using the Antimicrobial Resistance Surveillance Form for Probable & Confirmed Cases of Gonorrhoea Treatment Failure
• Laboratories that detect N. gonorrhoeae isolates with high level azithromycin resistance or resistance to extended spectrum cephalosporins are requested to send these isolates to the Interim National Gonococcal Reference Laboratory for molecular analysis and determination of antibiogram.
• Medical Officers of Health or Directors of Public Health notified of any suspected cases of treatment failure are requested to notify HPSC.

Public health response to suspected cephalosporin resistant Neisseria gonorrhoeae treatment failure

Flowchart for the Public Health management of a single case of suspected Cephalosporin Resistant treatment failure*: 

^{*Figure 7 from the National Guidelines for the Prevention and Control of Gonorrhoea and for minimising the impact of Antimicrobial Resistance in Neisseria gonorrhoeae, by the Antimicrobial Resistance in Neisseria gonorrhoeae Sub-Committee of the HPSC Scientific Advisory Committee}

^{Last updated: 18 December 2018}