Modern drugs of first choice for the treatment of gonorrhea should be widely available, low toxicity, cause eradication of gonococcus with a single use and quickly lead to the cure of infected patients. When choosing a method of treatment for gonococcal infection, WHO recommends a test for antimicrobial sensitivity, and in the absence of such an opportunity to use combination therapy. Monotherapy is allowed, but the choice of treatment depends on reliable local data on antimicrobial sensitivity. The article presents the outcomes of studies and results of treatments of patients with gonococcal infections, as well as the compliance of ongoing outpatient treatments according to clinical protocols approved in the Republic of Belarus by order N 1020 of 10.29.2009. It has been established that, due to the high resistance of gonococcus to penicillin, tetracycline and macrolide drugs, their use as monotherapy is impractical. The appointment of combination therapy (ceftriaxone + azithromycin) will not only reduce the risk of developing resistance to ceftriaxone, but also increase the effectiveness of treatment of under-examined patients with co-infection with C. Trachomatis.

1. Unemo, M. Antimicrobial Resistance Expressed by Neisseria gonorrhoeae: A Major Global Public Health Problem in the 21st Century / M. Unemo, C. del Rio, W. M. Shafer // Microbiology Spectrum. – 2016. – Vol. 10. – P. 213–237. – doi: 10.1128/microbiolspec.ei10-0009-2015

2. A systematic review and appraisal of the quality of practice guidelines for the management of Neisseria gonorrhoeaeinfections / C. Dickson [et al.] // Sexually Transmitted Infections. – 2017. – Vol. 93(7). – P. 487–492. – doi: 10.1136/sextrans-2016-052939

3. Gonorrhea: what goes around comes around / N. E. MacDonald [et al.] // Canadian Medical Association Journal. – 2011. – Vol. 183(14). – P. 1567–1567. – doi: 10.1503/cmaj.111393

4. Global Action Plan to Control the Spread and Impact of Antimicrobial Resistance in Neisseria gonorrhoeae / World Health Organization. – Geneva(Switzerland), 2012. – 36 p.

5. Suay-García, B. Future Prospects for Neisseria gonorrhoeae Treatment / B. Suay-García, M. Pérez-Gracia // Antibiotics. – 2018. – Vol. 7(2). – P. 49. – doi: 10.3390/antibiotics7020049

6. WHO guidelines for the treatment of Neisseria gonorrhoeae / World Health Organization. – Access mode: https://apps.who.int/iris/bitstream/handle/10665/246114/9789241549691-eng.pdf?sequence=1

7. Australasian Sexual Health Alliance. Australian STI Management Guidelines for Use in Primary Care. 2018. – Access mode: http://www.sti.guidelines.org.au/sexually-transmissible-infections/gonorrhoea

8. The antibiotic management of gonorrhoea in Ontario, Canada following multiple changes in guidelines: an interrupted time-series analysis / C. Dickson [et al.] // Sexually Transmitted Infections. – 2017. – Vol. 93(8). – P. 561–565. – doi: 10.1136/sextrans-2017-053224

9. Canadian guidelines on sexually transmitted infections: Gonococcal Infections Chapter / Public Health Agency of Canada. 2013. – Access mode: http://www.phac-aspc.gc.ca/std-mts/sti-its/cgsti-ldcits/assets/pdf/section-5-6-eng.pdf

10. Gonococcal Infections // Sexually transmitted diseases treatment guidelines / Centers for Disease Control and Prevention. 2015. – Access mode: http://www.cdc.gov/std/tg2015/gonorrhea.htm

11. European guideline on the diagnosis and treatment of gonorrhoea in adults / C. Bignell [et al.] // International Journal of STD & AIDS. – 2012. – Vol. 24(2). – P. 85–92. – Access mode: doi: 10.1177/0956462412472837

12. Дерматовенерология – 2015: Болезни кожи. Инфекции, передаваемые половым путем : федеральные клинические рекомендации. – М. : Деловой экспресс, 2016. – 5-е изд., перераб. и доп. – 768 с. – ISBN 978-5-89644-123-6

13. Клинический протокол диагностики и лечения пациентов с инфекциями, передаваемыми половым путем : Приложение 2 к приказу Министерства здравоохранения Республики Беларусь 29.10.2009, № 1020. – Режим доступа: https://medznate.ru/docs/index-21995.html