The patient with gonococcal infection.

Despite the availability of effective antimicrobial therapy since the middle of the twentieth century, gonococcal disease remains a common and expensive public health problem. The patient who presents to the primary care office with gonococcal disease, or one who is found to be infected after screening, still faces significant emotional and economic barriers to effective treatment and control of the spread of the disease. Along with the emergence of resistant strains and the previously existing problems of asymptomatic carriers and reluctance to seek treatment, physicians are charged with the problems of identifying patients at risk for the disease, providing effective treatment for those infected, and preventing further spread of infection. Simple, effective, and inexpensive therapies that also treat the frequently present coinfections with other sexually transmitted diseases are not yet available. Antibiotic therapy must still be chosen with regard to the patient's history and circumstances. The approach to counseling the patient about avoidance of complications, prevention of reinfection, and prevention of transmission of infection must be mastered by the primary care physician if progress is to be made toward the eradication of gonococcal disease.