*Treatment of Bacterial Sexually Transmitted Infections in Resource-Limited Settings DOI: http://dx.doi.org/10.5772/intechopen.109930*

inspection. Untreated gonococcal infection may lead to transient bacteremia, arthritis, or dermatitis. More severe sequelae, such as endocarditis and meningitis, are rare. Penicillinase-producing NG has rendered penicillin G inadequate therapy for infections caused by this organism.

The prevalence of NG in pregnancy in developing countries is between 10 and 20%. In sub-Saharan Africa, the prevalence of NG among high-risk groups in the 1980s was 7–66%, while among the low-risk groups in the same period was 0.3–40% [22–25]. The prevalence of the organism among high-risk groups in the 1990s was 6–31% and among the low-risk group in the same period was 1.6–9% [28–31]. Interestingly, this high prevalence is occurring in places where we have a paucity of manpower and equipment for the treatment of patients with the resultant high morbidity and mortality associated with the disease.

The confirmatory test for NG is by gram stain of directly visualized discharge or by culturing the organism on selective media, for example, Thayer-Martin. Where lubricant is needed during sample collection, water is recommended for use to avoid the reduction in a culture that may be occasioned by the use of antibacterial-containing lubricants. The non-culture techniques for the diagnosis of NG, for example, NAATs are becoming popular [31] but these diagnostic modalities are far-fetched in the resource-limited settings due to lack of equipment and personnel and also because patients patronize untrained personnel.

The CDC recommends the following treatment—Intramuscular Ceftriaxone 500 mg in a single dose for individuals with a total body weight of less than 150 kg. For patients in whom chlamydial infection has not been ruled out, treatment with oral doxycycline 100 mg twice daily for 7 days may be helpful. Patients who weigh ≥150 kg, should receive intramuscular ceftriaxone 1 g ceftriaxone in a single dose. Alternative treatment entails intramuscular Gentamicin 240 mg in a single dose plus oral Azithromycin 2 g in a single dose or oral Cefixime 800 mg in a single dose [1].
