Gonorrhea: diagnostic and therapeutic strategies in the era of resistance to antibiotics.

Culture procedures are the methods of choice for the diagnosis of gonorrhea, and they also allow for antibiotic susceptibility testing of isolated gonococcal strains. This is important because of the growing frequency in many countries of infections with antibiotic-resistant strains. The present report discusses the diagnosis, epidemiology, and various modes for treatment of infections with plasmid-mediated high-level penicillin- and high-level tetracyclin-resistant gonococcal strains, as well as infections with gonococcal strains with chromosomally mediated resistance to penicillin, spectinomycin, and other antibiotics, such as the quinolones. The importance of subjecting treated patients to tests of cure is stressed, as well as the need for continous surveillance studies and strategies for control.