UW Center for AIDS and STD

Consultation for Suspected Gonorrhea Treatment Failures & Specimen Submission

When to suspect a gonorrhea treatment failure?

Suspected treatment failures are:

  1. Persons with symptomatic gonococcal infections whose symptoms do not resolve in 3-5 days following treatment and report no sexual contact following treatment, and
  2. Persons with a positive test of cure (TOC) by culture >72 hours after treatment when no sexual contact is reported between treatment and TOC.  **Note, PHSKC does not recommend routine test of cure.  TOC are recommended when:
    • alternative drugs are used, particularly when used for pharyngeal gonorrhea, and
    • in pregnant persons

What to do if you suspect a gonorrhea treatment failure?

Contact us! We are here to help.  We can help providers in Washington State with two aspects of potential gonorrhea treatment failure investigation and management:

  1. We can help with clinical management, including alternative treatment regimens.
  2. We can help with culture, antimicrobial susceptibility, and molecular testing of the suspected treatment failure isolate.


This will help you, as well as local public health and the CDC determine if your case has a gonococcal strain of public health concern.

Please email golden@uw.edu to be connected with Dr. Matthew Golden for a case consult.

How to submit specimens for laboratory diagnostics and culture?

For cases of suspected treatment failure, the University of Washington Neisseria Reference Laboratory can accept gonococcal specimens for antimicrobial susceptibility testing.  When you contact us for a case consult, the PHSKC gonorrhea team can assist with specimen submission by supplying the appropriate specimen collection & transport system if needed, and coordinate delivery to the lab.