Verifying Treatment of Reported Cases of Gonorrhea

Verifying correct treatment of reported cases of gonorrhea may slow antibiotic resistance, but verification remains challenging for many sexually transmitted disease (STD) programs due to increased laboratory case reporting and decreased provider reporting. The objectives of this study were to document current reported levels of correct treatment of gonorrhea and to identify approaches and barriers to verifying treatment.

We reviewed funding opportunity reports for the Centers for Disease Control and Prevention's directly funded STD programs and conducted key-informant interviews to elicit further treatment verification details.

Among STD programs containing at least one high-morbidity area, a median of 63.0% of gonorrhea cases were reported as treated correctly with a Centers for Disease Control and Prevention-recommended regimen, although the range reported was wide (11.2%-95.2%). Among cases with some type of documented treatment information, the proportion treated correctly was higher (median, 82.2%) but the use of correct treatment was quite variable among STD programs (range, 56.4%-98.5%). Approaches to verifying gonorrhea treatment included modifying outdated surveillance systems and educating providers about case reporting to enhance the passive capture of treatment information as well as active approaches that supported routine and immediate communication with providers regarding cases missing treatment information. Barriers to treatment verification included low levels of provider reporting, outdated surveillance systems, and human and financial resource constraints.

Baseline assessments revealed that levels of correct gonorrhea treatment vary widely, even after accounting for those cases missing treatment information. Baseline data can help determine whether the active verification of treatment of all cases is warranted.