NSW Health had a recent notification of a locally acquired, extensively drug resistant (XDR) gonorrhoea. The XDR showed high level resistance and decreased susceptibility to first line drugs, azithromycin and ceftriaxone, used in the treatment of gonorrhoea.
This comes as a timely reminder to ALWAYS collect a gonococcal culture to determine antimicrobial sensitivity PRIOR to administering treatment for gonorrhoea – but don’t delay treatment.
An endocervical swab collected by a clinician is the ideal investigation. However a self-collected high vaginal swab is often more acceptable for patients.
Refer to the Australian STI Management Guidelines for further information and management of gonorrhoea.
*Hot Tip* – Place your swabs next to your ceftriaxone stock as a reminder to collect a culture before treating your patients.
UPDATE: On 28th March 2025, NSW Health released a new gonorrhoea alert.
An additional case of overseas-acquired XDR gonorrhoea was reported to NSW Health this month.
The health alert emphasises the importance of obtaining a travel history from patients (including partners’ travel) during STI screenings. Of particular concern is any potential exposure to gonorrhoea in South-East Asia, where there is an increase in drug-resistant gonorrhoea.
Please find the NSW Health Alert here and share amongst your colleagues.
If you have any questions, please contact publichealth@ahmrc.org.au
