Objectives To determine the time to resolution of symptoms (TTR) following treatment of uncomplicated gonorrhoea and to identify factors associated with TTR in a cohort of sexual health clinic attendees.
Methods Participants were recruited from 14 clinics across England into the ‘Gentamicin for the Treatment of Gonorrhoea (GToG)’ trial between October 2014 and November 2016. We analysed demographic, behavioural and clinical data in a subset of the GToG study cohort presenting with genital discharge and/or dysuria, who subsequently experienced microbiological clearance of Neisseria gonorrhoeae 2 weeks after treatment. Testing for gonorrhoea was performed using a nucleic acid amplification test. The results were expressed as median TTR (IQR) and HRs with 95% CIs for resolution of symptoms.
Results 216 participants (89% male) with a mean age of 32 years reported genital discharge (204/216 (94%)) or dysuria (173/216 (80%)) at their baseline visit. Symptom resolution occurred in 202/216 (94%) at the 2-week follow-up appointment. The median TTR was 2 days (IQR 1–3 days). 50/216 (23%) patients presented with gonorrhoea–chlamydia coinfection at their baseline attendance and in this group symptom resolution was slower (3 days for gonorrhoea–chlamydia coinfection compared with 2 days for gonorrhoea only, HR 0.68 (95% CI 0.48 to 0.95)). TTR was also longer in women (4 days for females compared with 2 days for males, HR 0.47 (95% CI 0.29 to 0.77)).
Conclusions The time to resolution of genital symptoms following effective treatment of gonorrhoea is variable, but 90% of patients report symptom resolution within 1 week. Concurrent chlamydia infection and being female were associated with prolonged TTR.
- epidemiology (general)
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Handling editor Jason J Ong
Contributors JDCR conceived the study. Both authors contributed to the design of the study. OA carried out the statistical analyses. Both authors drafted the manuscript. All authors assisted with interpretation of the data, reviewed and approved the final manuscript.
Funding This study was funded by the National Institute for Health Research (NIHR) Health Technology Assessment and registered prior to start of recruitment (ISRCTN51783227).
Disclaimer The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.
Competing interests JDCR reports personal fees from GSK Pharma, Hologic Diagnostics, Mycovia and Janssen Pharma as well as ownership of shares in GSK Pharma and AstraZeneca Pharma; is author of the UK and European Guidelines on Pelvic Inflammatory Disease; is a Member of the European Sexually Transmitted Infections Guidelines Editorial Board; is a Member of the National Institute for Health Research Funding Committee (Health Technology Assessment programme); and was previously a Member of the National Institute for Health Research HTA Primary Care, Community and Preventative Interventions Panel (2013-2016). He is an NIHR Journals Editor and associate editor of Sexually Transmitted Infections journal. He is an officer of the British Association for Sexual Health and HIV (vice-president) and the International Union against Sexually Transmitted Infections (treasurer), and a charity trustee of the Sexually Transmitted Infections Research Foundation.
Patient consent for publication Not required.
Ethics approval Ethics approval for the 'Gentamicin for the Treatment of Gonorrhoea' trial was obtained from the Health Research Authority South Central–Oxford C Research Ethics Committee (14/SC/1030).
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available on reasonable request.
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