Gonorrhoea Test of Cure Failure — SCE Infectious Diseases MCQ

Correct answer: D — Obtain gonococcal culture with antimicrobial susceptibility testing and urgently involve the specialist/UKHSA pathway for possible treatment failure with review after review with follow-up

The best answer is “Obtain gonococcal culture with antimicrobial susceptibility testing and urgently involve the specialist/UKHSA pathway for possible treatment failure with review after review with follow-up”. Possible cephalosporin treatment failure requires a viable isolate, susceptibility data and public-health escalation before further treatment obscures the result. “Assume residual nucleic acid and discharge without follow-up” is less appropriate because it does not satisfy the scenario's decisive clinical or jurisdictional requirement. “Give empirical azithromycin monotherapy before collecting culture” is less appropriate because it does not satisfy the scenario's decisive clinical or jurisdictional requirement. “Repeat the same ceftriaxone dose without susceptibility testing” is less appropriate because it does not satisfy the scenario's decisive clinical or jurisdictional requirement. “Diagnose reinfection despite the documented absence of sexual exposure” is less appropriate because it does not satisfy the scenario's decisive clinical or jurisdictional requirement.

Reference: BASHH gonorrhoea guideline 2025: https://www.bashh.org/resources/136/gonorrhoea-2025/