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. COMPOSITION OF THE GUIDELINE DEVELOPMENT GROUP 12 -- 1.1. COMPOSITION OF THE GUIDELINE DEVELOPMENT GROUP 12 -- 1.2. COMPOSITION OF THE KCE EXPERT TEAM 13 -- 1.3. EXTERNAL RESEARCHERS INVOLVED IN THE GUIDELINE DEVELOPMENT 13 -- 2. SEARCH STRATEGIES 14 -- 2.1. GENERAL LITERATURE SEARCH 14 -- 2.1.1. Ovid MEDLINE 14 -- 2.1.2. Cochrane 15 -- 2.1.3. Embase 17 -- 2.1.4. Study flow for general literature search 21 -- 2.2. ADDITIONAL SEARCH FOR DIAGNOSIS OF GONORRHOEA 22 -- 2.2.1. Medline 22 -- 2.2.2. Central 22 -- 2.2.3. Study flow of selection of primary studies 22 -- 2.2.4. Excluded studies 24 -- 2.3. ADDITIONAL SEARCH FOR TREATMENT OF GONORRHEA 28 -- 2.3.1. Medline 28 -- 2.3.2. Embase 29 -- 2.3.3. Cochrane 30 -- 2.3.4. Study flow of selection of primary studies 31 -- 2.3.5. Excluded studies 33 -- 2.4. ADDITIONAL SEARCH FOR DIAGNOSIS OF SYPHILIS 35 -- 2.4.1. Medline 35 -- 2.4.2. Cochrane 36 -- 2.4.3. Study flow of selection of systematic reviews and primary studies 37 -- 2.4.4. Excluded studies 38 -- 2.5. ADDITIONAL SEARCH FOR TREATMENT OF SYPHILIS 39 -- 2.5.1. Medline 39 -- 2.5.2. Embase 40 -- 2.5.3. Cochrane 40 -- 2.5.4. Pubmed 41 -- 2.5.5. Excluded studies 43 -- 3. GUIDELINES IDENTIFIED 44 -- 3.1. TOPIC: DIAGNOSIS AND/OR MANAGEMENT OF GONORRHOEA 44 -- 3.2. TOPIC: DIAGNOSIS AND/OR MANAGEMENT OF SYPHILIS 45 -- 4. GUIDANCE DOCUMENTS AND CONSULTATION ALGORITHMS FOR THE TOOL 46 -- 5. GUIDANCE DOCUMENTS FOR PARTNER MANAGEMENT 48 -- 6. QUALITY APPRAISAL 50 -- 6.1. QUALITY APPRAISAL TOOLS 50 -- 6.1.1. Guidelines 50 -- 6.1.2. Diagnostic accuracy studies 54 -- 6.1.3. Primary studies for therapeutic interventions 59 -- 7. EVIDENCE TABLES BY CLINICAL QUESTION 73 -- 7.1. DIAGNOSIS OF GONORRHEA 73 -- 7.1.1. Nucleic acid amplification Tests (NAATs) and culture 73 -- 7.2. TREATMENT OF GONORRHOEA 136 -- 7.2.1. Sexually active women and men including adolescents 136 -- 7.2.2. Pregnant women 144 -- 7.2.3. People with an allergy to cephalosporin 150 -- 7.3. DIAGNOSIS OF SYPHILIS 150 -- 7.3.1. Screening strategies 151 -- 7.3.2. Polymerase Chain Reaction (PCR) assay 154 -- 7.3.3. Enzyme Immunoassay (EIA) 157 -- 7.3.4. Rapid point of care (POC) tests for syphilis 161 -- 7.4. TREATMENT OF SYPHILIS 177 -- 7.4.1. Research question 7  What is the recommended treatment for uncomplicated syphilis in sexually active women and men including young people? 177 -- 7.4.2. Research question 8  What is the recommended treatment for uncomplicated syphilis in case of allergy to penicillin? 211 -- 8. FOREST PLOTS 212 -- 8.1. N. GONORRHOEA AND C. TRACHOMATIS: DIAGNOSIS 212 -- 8.2. N. GONORRHOEA: TREATMENT 219 -- 8.2.1. Sexually active women and men including young people 219 -- 8.2.2. Pregnant women 224 -- 8.2.3. People with severe cephalosporin allergy 228 -- 8.3. SYPHILIS: DIAGNOSIS 228 -- 8.4. SYPHILIS: TREATMENT 230 -- 8.4.1. Treatment of syphilis in women and men including young people 230 -- 8.5. RESEARCH QUESTION 8: TREATMENT OF SYPHILIS IN ADULTS IN CASE OF ALLERGY -- TO PENICILLIN 248 -- 9. SUMMARY OF FINDINGS TABLES AND GRADE PROFILES 249 -- 9.1. NEISSERIA GONORRHEA: DIAGNOSIS 249 -- 9.2. CHLAMYDIA TRACHOMATIS (ONLY FOR TMA APTIMA COMBO TEST): DIAGNOSIS 254 -- 9.3. NEISSERIA GONORRHEA: TREATMENT 256 -- 9.3.1. Treatment of gonorrhea in sexually active women and men 256 -- 9.3.2. Treatment for pregnant women 260 -- 9.3.3. Treatment for people with severe cephalosporin allergy 262 -- 9.4. SYPHILIS: DIAGNOSIS 262 -- 9.5. SYPHILIS: TREATMENT 266 -- 10. NEISSERIA GONORRHOEA RESISTANCE: BELGIAN DATA 278 -- 11. 6 STEPS FOR TESTING STIS IN A SEXUAL HEALTH CONSULTATION 280 -- STEP 1: STARTING A CONVERSATION ABOUT SEXUAL HEALTH TESTING 280 -- STEP 2 : SEXUAL HISTORY QUESTIONS FOR READINESS, NEEDS AND RISK ASSESSMENT 281 -- STEP 3 : STI TESTING OVERVIEW 282 -- STEP 4 : HOW TO TEST 284 -- STEP 5 : TREATMENT OVERVIEW - TEST OF CURE - FOLLOW UP 285 -- STEP 6 : PARTNER MANAGEMENT AND CONTACT 287 -- REFERENCES 289