Following treatment, a test of cure (TOC) is recommended for all individuals treated for gonorrhoea in the UK, as per British Association for Sexual Health and HIV (BASHH) and Health Protection Surveillance Centre (HPSC) guidelines NICE CKS Fifer 2020HPSC 2016. This approach differs from the US Centers for Disease Control and Prevention (CDC), which states that TOC is not needed for uncomplicated urogenital or rectal gonorrhoea treated with recommended regimens NICE CKS CDC 2021.
For TOC, if signs or symptoms persist, culture should be performed at least 3 days after treatment completion NICE CKS. If this culture is negative, additional NAAT testing can be considered after 1 week for increased sensitivity NICE CKS. If the person is asymptomatic, nucleic acid amplification testing (NAAT) is recommended where available, followed by culture if positive, at least 2 weeks after treatment completion NICE CKS. The time for a negative TOC using NAATs varies, but most individuals should test negative 7 days following treatment with an RNA NAAT or 14 days following treatment with a DNA NAAT NICE CKS. All individuals diagnosed with gonorrhoea should be referred promptly to a genito-urinary medicine (GUM) clinic or other local specialist sexual health service for comprehensive management NICE CKS RCGP 2013.