Gonorrhea: the office management of acute infections

Gonorrhea has recently increased to epidemic proportions and is poorly controlled. The principal causes are probably increasing resistance of Neisseria gonorrheae to penicillin, the difficulty of establishing the diagnosis and proving the cure in female patients and the inadequacy of resources devoted to the eradication of the disease by public health agencies. While examination of smears is adequate for diagnosis of the disease in males, in females cultures of vaginal exudate are necessary. Gonorrhea can usually be successfully treated with large doses of short-acting penicillins. Intramuscular administration of aqueous procaine penicillin will bring about cure in most cases. Female patients should have cultures for several weeks to make sure they are cured. The physician should report all cases to the local health department so that contacts can be traced and treated.