Failure to control gonorrhoea

There is increasing evidence of emerging resistance of the gonococcus to antibiotics, particularly penicillin, but apparent resistance may sometimes be due to concomitant infection with micro-organisms other than the gonococcus, which are not susceptible to this antibiotic. There is also evidence that clinical complications, particularly in the female, are much more frequent than was previously believed to be the case. The incidence of gonorrhoea has increased significantly in many countries in spite of the availability of the "ideal" drug, penicillin. The reasons for the failure to control gonorrhoea in the individual and in the mass of patients are discussed, taking into account a number of factors relating to emerging drug resistance of the gonococcus, insufficient criteria for diagnosis, the possibility of persistence of infection and increased frequency of reinfection.