![]() 2 Researchers are very concerned about gonorrhea’s ability to develop resistance to ceftriaxone, because it has the potential to become resistant to all antibiotics, which would create a superbug. The recommended treatment for gonorrhea has included penicillin, sulfonamides, tetracycline, fluoroquinolones, spectinomycin, macrolides, and now cephalosporins. Gonorrhea has a notable history for its ability to develop resistance against most recommended treatments. In particular, there is increasing concern about the development of a ceftriaxone-resistant gonorrhea strain. However, this practice is leading to overtreatment, which is rapidly causing resistance to drugs. 1 Because of these serious consequences, I feel it is incredibly important to make sure anyone who has an STI gets treatment, and that it is better to treat even if that means some people get treated unnecessarily. If untreated, these infections can cause serious health issues such as pelvic inflammatory disease (PID) and infertility in women. According to the CDC, there are an estimated 2.86 million cases of chlamydia and 820,000 cases of gonorrhea reported annually in the United States. Unfortunately, this practice leaves me with mixed feelings. These patients also have a 72-hour window before they receive their results, and during this time they have the potential to infect others. I’ve been told in the past that reason we are so quick to treat for gonorrhea and chlamydia is because these patients may not give reliable contact information to be notified of positive results, and there is also a chance that they may not come back for treatment if notified of their positive results. A woman with vaginal discharge, known exposure, or dyspareunia will also often get treated while in the emergency department before her culture results are available. We will also treat someone for gonorrhea and chlamydia if he or she presents with herpetic lesions and has had sexual intercourse with someone who was diagnosed with an STI. ![]() If a man has penile discharge, we will send a culture for gonorrhea and chlamydia, and then treat him before he leaves the emergency department even if we don’t have the test results back yet. Whenever patients come into the emergency department with concerns about a sexually transmitted infection (STI), we are very quick to treat them.
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