Primary prevention
Primary prevention includes education of adolescents about safe sex practices, including abstinence. Once sexually active, all people should be educated about safe sex practices, encouraged to use condoms, and informed that limiting the number of sex partners can reduce the risk of infection.
Secondary prevention
Patients should be instructed in safe sex practices. All sex partners within the last 60 days should be referred for evaluation and possible treatment. Use of prophylactic antibiotics is discouraged.[55][56]
Studies have examined the practice of expedited partner therapy (where patients are given medication to treat sex partners). [
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In the US, laws governing expedited partner therapy vary by state. Local health department should be contacted to determine the legality of this practice in each area.[1][45][46][47] These programmes are controversial because, while effective for reducing transmission of gonorrhoea and chlamydial urethritis, they omit the opportunity to provide in-person contact, counselling, detection of other sexually transmitted infections (STIs), or detection of patient allergies.[48]People should be tested for other STIs, including HIV and syphilis. Patients who are given a specific diagnosis of chlamydia, gonorrhoea, or trichomonas should be re-tested 3 months after treatment, as rates of reinfection are reported to be high, regardless of whether their sex partners were treated.
Pregnant women should be re-tested to ensure cure, preferably with a nucleic acid amplification test such as ligase chain reaction or polymerase chain reaction of urethral discharge and/or urine sediment. Chlamydia test of cure is recommended 4 weeks after treatment, with a re-test at 3 months. Re-test for gonorrhoea is recommended at 3 months.[1]
Prophylactic ocular antimicrobial medication is strongly recommended for all newborns exposed to Neisseria gonorrhoeaeand is mandatory in some countries.[1]
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