Gonorrhoea management in the UK relies on NICE for broad sexual health frameworks and referral pathways, and on the British Association for Sexual Health and HIV (BASHH) for resistance-aware microbiological guidance and specific treatment regimens. This comparison highlights how to use both in 2025.
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Audience: GPs, sexual health clinicians, pharmacists, and ED/urgent care teams who need fast, trusted direction on diagnosis, treatment, and test-of-cure.
Diagnosis and testing
NICE
- Positions gonorrhoea within a broad sexual health framework.
- Referral-oriented: encourages testing and management in specialist sexual health services.
- NAATs as primary diagnostic tools; partner notification signposted.
BASHH
- Provides detailed microbiological guidance, including site-specific sampling (urogenital, rectal, pharyngeal) based on exposure.
- Resistance-aware protocols: culture and susceptibility testing when feasible, especially for pharyngeal infection or suspected resistance.
- Clear guidance on partner notification and retesting windows.
Key difference: NICE frames pathways and referrals; BASHH gives operational microbiology detail and resistance management.
Treatment
NICE
- Defers specific regimens to specialist guidance; emphasises timely referral and follow-up.
BASHH
- Specifies resistance-aware regimens (e.g., ceftriaxone dosing; dual therapy if indicated), tailored to local susceptibility patterns.
- Mandates test-of-cure (particularly for pharyngeal infection) and retesting at recommended intervals.
- Detailed partner notification and public health actions.
Key difference: NICE defines the pathway; BASHH defines the exact regimen, test-of-cure requirements, and resistance considerations.
Practical flow you can apply
- Test appropriately: Use NAATs at exposure sites; consider culture for susceptibility where available.
- Follow specialist regimens: Use BASHH-recommended antibiotics and doses; note local resistance alerts.
- Test-of-cure: Especially for pharyngeal infection; follow BASHH timing (typically 2 weeks post-treatment).
- Partner notification: Initiate promptly; follow BASHH guidance on look-back periods and retesting.
- Safety-net: Advise on abstinence until clearance; re-test per guideline; ensure follow-up of positive partners.
FAQs: quick answers
Which guideline sets the treatment regimen? BASHH. NICE signposts specialist care and frameworks.
Is test-of-cure required? Yes, especially for pharyngeal infection or where resistance is a concern (per BASHH timing).
Do both discourage empirical antibiotics without testing? Yes; test and treat with recommended regimens, and consider culture for resistance.
How to handle resistance alerts? Follow BASHH updates and local microbiology advice; adjust regimens accordingly.
What about partner notification? Both endorse it; BASHH provides detailed protocols.
Source links (official)
- NICE CG140 – Sexually transmitted infections
- BASHH – Gonorrhoea guidelines and updates
- CliniSearch guideline hub
Why this matters
Gonorrhoea management depends on timely diagnosis, resistance-aware treatment, and robust partner notification. NICE provides the pathway and referral framework; BASHH provides the treatment details, susceptibility considerations, and test-of-cure expectations. Using both keeps care safe, current, and aligned with antimicrobial stewardship.