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Abstract：
Gonorrhoea is a major public health concern globally. Increasing incidence and sporadic ceftriaxone-resistant cases, including treatment failures, are growing concerns. The 2020 European gonorrhoea guideline provides up-to-date evidence-based guidance regarding the diagnosis and treatment of gonorrhoea. The updates and recommendations emphasize significantly increasing gonorrhoea incidence; broad indications for increased testing with validated and quality-assured nucleic acid amplification tests (NAATs) and culture; dual antimicrobial therapy including high-dose ceftriaxone and azithromycin (ceftriaxone 1 g plus azithromycin 2 g) OR ceftriaxone 1 g monotherapy (ONLY in well-controlled settings, see guideline for details) for uncomplicated gonorrhoea when the antimicrobial susceptibility is unknown; recommendation of test of cure (TOC) in all gonorrhoea cases to ensure eradication of infection and identify resistance; and enhanced surveillance of treatment failures when recommended treatment regimens have been used. Improvements in access to appropriate testing, test performance, diagnostics, antimicrobial susceptibility surveillance and treatment, and follow-up of gonorrhoea patients are essential in controlling gonorrhoea and to mitigate the emergence and/or spread of ceftriaxone resistance and multidrug-resistant and extensively drug-resistant gonorrhoea. This review provides the detailed background, evidence base and discussions, for the 2020 European guideline for the diagnosis and treatment of gonorrhoea in adults (Unemo M, et al. Int J STD AIDS. 2020).
摘要：
淋病是全球主要的公共卫生问题。发病率增加和偶发性头孢曲松耐药病例，包括治疗失败，越来越多的担忧。2020年欧洲淋病指南为淋病的诊断和治疗提供了最新的循证指导。更新和建议强调显著增加淋病的发病率;广泛的适应症增加测试与验证和质量保证的核酸扩增测试(NAAT)和培养;双重抗菌治疗包括大剂量头孢曲松和阿奇霉素(头孢曲松1g+阿奇霉素2g)或头孢曲松1g单药治疗(仅在良好控制的环境中,详情见指南)在抗菌药物敏感性未知时,无并发症淋病;建议对所有淋病病例进行治愈试验(TOC),以确保根除感染并确定耐药性;在使用推荐治疗方案时,加强对治疗失败的监测。改善获得适当测试的机会，测试性能，诊断,抗菌药物敏感性监测和治疗，淋病患者的随访对于控制淋病和减轻头孢曲松耐药和多药耐药和广泛耐药淋病的出现和/或传播至关重要。这篇综述提供了详细的背景，证据基础和讨论，对于2020年欧洲成人淋病诊断和治疗指南(UnemoM，etal.国际性病艾滋病。2020）。
