There are two important steps to treating a sexually transmitted disease, especially one as easily spread as gonorrhea. The first is to cure the infected person. The second is to locate and test all of the person's other sexual contacts and to treat them to prevent further spread of the disease.

That is why mandatory reporting has been instituted and has, until recently, held the number of cases of gonorrhea at a low level. However, the number of infections is once again rising.

Even though penicillin is effective against gonorrhea, there have been increasing numbers of strains that are resistant to penicillin (they don't respond to penicillin treatment). Because of this, gonorrhea is now treated by a large number of new and very potent antibiotics. More recently, resistance to antibiotics such a ciprofloxacin, ofloxacin (or levoflaxacin), and enoxacin has become a problem.

Common prescriptions are one of the following:

• ceftriaxone 125 mg injected into a muscle, one time
• cefixime 400 mg by mouth, one time
• ciprofloxacin 500 mg by mouth, one time
• ofloxacin 400 mg by mouth, one time
• cefuroxime Axotal 1 g by mouth, one time
• cefpodoxime proxetil 200 mg by mouth, one time
• enoxacin 400 mg given by mouth, one time

A follow-up visit 7 days after treatment to recheck cultures and confirm the cure of infection is important, especially for women who may not have symptoms associated with the infection.

When gonorrhea is treated immediately upon onset, the outcome is likely to be good, meaning that no permanent scarring will have taken place and fertility will be maintained. When treatment is delayed there is a greater likelihood of complication and a high probability of sterility.

Untreated gonorrhea may spread to other parts of the body causing disseminated infection. The following is a list of possible complications:

• salpingitis
• pelvic inflammatory disease
• peritonitis
• bacteremia (gonococcemia)
• gonococcal arthritis
• gonococcal pharyngitis
• ophthalmia neonatorum (gonococcal conjunctivitis)
• vulvovaginitis
• sterility
• dyspareunia

If you have symptoms suggestive of gonorrhea, you should call your health care provider immediately. If you are short of funds or uninsured, state sponsored Sexually Transmitted Disease Clinics will diagnose and treat STDs without charge.

Using a state sponsored clinic allows the state to keep accurate statistics on the number of cases and to treat other infected contacts who would otherwise spread the disease.

Women who have engaged in high risk sexual practices (unprotected sex, multiple partners, unknown partners and so on) should be periodically examined to check for the presence of asymptomatic disease.