Ann Intern Med 17 Jul 2007 Vol 147

When penicillin was a new drug in short supply, its use in gonorrhea became the subject of heated debate; after that, decades passed before the first penicillin-resistant gonococci emerged and led to the abandonment of penicillin in favour of fluoroquinolone antibiotics. Now these in turn are losing their effectiveness, according to a survey of gonococcal resistance in the USA between 1988 and 2003. But penicillin sensitivity has returned widely to prevalent gonococci and there are many other antibiotics to which they remain susceptible.

One person in 400 between the ages of 14 and 39 in the USA has gonorrhea, but ten times that number have chlamydia. This is a major cause of female infertility and pelvic pain, and they like us, fret about the best screening strategy. The US Preventive Services Task Force takes its evidence-gathering seriously and there are two methodology papers here  plus a summary of their systematic review and the recommendations themselves which are:
* Screen all sexually active women age 24 or younger
* Screen older pregnant women at increased risk
* Do not screen age 25 or older unless at increased risk
* Not enough evidence to screen men.
But follow different guidelines in the UK.