Diagnosis and management of gonorrhoea and syphilis
Authors: Jespers Vicky , Stordeur Sabine , Desomer Anja , Carville Serena , Jones Clare , Lewis Sedina , Perry Mark , Cordyn Sam , Cornelissen Tine , Crucitti Tania , Danhier Céline , De Baetselier Irith , De Cannière Anne-Sophie , Dhaeze Wouter , Dufraimont Els , Kenyon Chris , Libois Agnes , Mokrane Saphia , Padalko Elizaveta , Van Den Eynde Sandra , Vanden Berghe Wim , Van Der Schueren Thierry , Dekker Nicole 
Published: January 2025

1 INTRODUCTION 7 -- BACKGROUND 7 -- REMIT OF THE GUIDELINE 9 -- 1.2.1 Objectives of the guideline 9 -- 1.2.2 Patient-centered care 9 -- 2 METHODOLOGY 10 -- THE GUIDELINE DEVELOPMENT GROUP 10 -- CLINICAL RESEARCH QUESTIONS 10 -- GENERAL APPROACH 11 -- QUALITY ASSESSMENT OF STUDIES 11 -- FORMULATION OF RECOMMENDATIONS 12 -- EXTERNAL REVIEW 12 -- FINAL VALIDATION 12 -- 3 CLINICAL RECOMMENDATIONS FOR MANAGEMENT OF GONORRHOEA 14 -- GONORRHOEA DIAGNOSIS 14 -- 3.1.1 Recommendations: Who to test for gonorrhoea 14 -- 3.1.2 Recommendations: Diagnostic tests for gonorrhoea 16 -- 3.1.3 Diagnosis of gonorrhoea: Good practice statements 18 -- GONORRHOEA TREATMENT 19 -- 3.2.1 Recommendations regarding information and advice for the patient 19 -- 3.2.2 Recommendations regarding testing and surveillance for resistance 20 -- 3.2.3 Recommendation regarding initiation of therapy 20 -- 3.2.4 Referral to the second line for gonorrhoea: Good practice statements 21 -- 3.2.5 Recommendation for treatment of gonorrhoea in women and men including young people 21 -- 3.2.6 Treatment of gonorrhoea: Good practice statements 22 -- 3.2.7 Recommendation for treatment of gonorrhoea in pregnant women 22 -- 3.2.8 Treatment of gonorrhoea in pregnant women: Good practice statements 23 -- 3.2.9 Treatment of gonorrhoea in people with an allergy to cephalosporin: Good practice statement 23 -- 3.2.10 Recommendations for treatment of chlamydia and gonorrhoea co-infection 24 -- GONORRHOEA TEST OF CURE AND FREQUENCY OF TESTING 25 -- 3.3.1 Recommendations regarding a test of cure for gonorrhoea 25 -- 3.3.2 Recommendations regarding testing frequency for gonorrhoea 26 -- MANDATORY NOTIFICATION OF GONORRHOEA 26 -- 4 CLINICAL RECOMMENDATIONS FOR MANAGEMENT OF SYPHILIS 27 -- SYPHILIS DIAGNOSIS 27 -- 4.1.1 Recommendations: Who to test for syphilis 27 -- 4.1.2 Recommendations: Which sample to take for syphilis 28 -- 4.1.3 Recommendation: Which tests to use for syphilis 29 -- 4.1.4 Choice of tests for syphilis diagnosis: Good practice statements 30 -- SYPHILIS TREATMENT 30 -- 4.2.1 Recommendations regarding syphilis information and advice for the patient 30 -- 4.2.2 Recommendation regarding initiation of syphilis therapy 31 -- 4.2.3 Recognising syphilis clinical symptoms: Good practice statements 31 -- 4.2.4 When to refer to the second line for syphilis: Good practice statements 32 -- 4.2.5 Recommendations for treatment of syphilis in women and men including young people (excluding pregnant women) 32 -- 4.2.6 Treatment of syphilis: Good practice statements 33 -- SYPHILIS FOLLOW-UP AND FREQUENCY OF TESTING 34 -- 4.3.1 Recommendations regarding follow-up of a treated patient 34 -- 4.3.2 Testing frequency for syphilis: Good practice statements 35 -- MANDATORY NOTIFICATION OF SYPHILIS 35 -- 5 IMPLEMENTATION OF THIS GUIDELINE 36 -- POLICY AND OTHER IMPLEMENTATION OF THIS GUIDELINE 36 -- 5.1.1 Barriers and facilitators 36 -- 5.1.2 Actors of dissemination and publication on Ebpractice net 36 -- TRANSLATING THE GUIDELINE INTO A PRIMARY CARE SEXUAL HEALTH CONSULTATION STI TESTING INSTRUMENT 37 -- 5.2.1 Clinical guidance 37 -- 5.2.2 Structure of the STI consultation instrument 37 -- 6 GUIDELINE UPDATE 39 -- RECOMMENDATIONS 40 -- REFERENCES 42