Box 3.3. Treatment must be initiated without waiting for the test results

A. On epidemiological grounds

if a recent partner has a conﬁrmed gonococcal infection
in the mother of a newborn with a conﬁrmed gonococcal infection

B. In case of the following symptoms, after specimen collection for laboratory testing

purulent urethral discharge in men
proctitis in MSM
mucopurulent cervicitis in women

C. If follow-up cannot be guaranteed (after specimen collection for laboratory testing)

Some patients should be referred immediately to secondary care

when first-line treatment is not available or the patient has not tolerated it in the past
in case of a known or documented allergy to cephalosporins
in case of complicated infection: epididymo-orchitis, prostatitis, (suspected) acute salpingitis or endometritis, conjunctivitis or disseminated gonococcal infection