{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T14:12:32Z","timestamp":1790172752424,"version":"4.1.0"},"reference-count":27,"publisher":"BMJ","issue":"8","funder":[{"DOI":"10.13039\/501100000664","name":"Health Technology Assessment Programme","doi-asserted-by":"publisher","award":["ISRCTN51783227"],"award-info":[{"award-number":["ISRCTN51783227"]}],"id":[{"id":"10.13039\/501100000664","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2020,6,16]]},"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>\n                     <jats:italic>Neisseria gonorrhoeae<\/jats:italic> (NG) infection can resolve without antibiotic treatment, however the literature describing the frequency of clearance at individual sites, how rapidly it occurs and potential predictive factors is limited. In this analysis of a subpopulation identified from a large multicentre UK cohort, we describe the overall rate of spontaneous clearance of infection and explore factors associated with this.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Data from the Gentamicin compared with Ceftriaxone for the Treatment of Gonorrhoea randomised controlled trial consisting of 720 patients with NG were analysed. A subgroup of individuals had both a pretrial test sample and a trial enrolment sample taken. Those who had cleared NG between initial presentation and subsequent entry into the trial without antibiotic treatment were deemed to have spontaneously cleared. Sociodemographic characteristics, sexual history and sites of infection for those who spontaneously cleared infection were compared with that of those who did not. We also estimated the time interval to clearance.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Overall, the proportion who had spontaneous clearance was 20.5% (83\/405). Clearance of infection occurred over a median of 10 days (IQR 7\u201315 days). The cohort who spontaneously cleared were similar to those who did not in terms of age, gender, sexual orientation, HIV status and previous NG infection. Chlamydia coinfection was more frequent in the \u2018no spontaneous clearance group\u2019 (11.1% (9\/83) cf 22.0% (69\/322)) (p=0.029). Dysuria was reported more often in the \u2018no spontaneous clearance group\u2019 (4.8% (4\/83) cf 13.0% (42\/322)) (p=0.035).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>We present data from a large cohort of NG-infected individuals, of whom a significant proportion had spontaneous clearance of infection. This is consistent with previous smaller studies. If this is indicative of cure, point-of-care testing prior to treatment has the potential to reduce unnecessary exposure to antimicrobials. Further work to assess the importance of bacterial load, genotype and host immune response on spontaneous clearance of infection is required.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Trial registration number<\/jats:title>\n                  <jats:p>\n                     <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"ISRCTN51783227\">ISRCTN51783227<\/jats:ext-link>\n                  <\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/sextrans-2020-054500","type":"journal-article","created":{"date-parts":[[2020,7,30]],"date-time":"2020-07-30T19:02:41Z","timestamp":1596135761000},"page":"556-561","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":33,"title":["Spontaneous clearance of genital and extragenital <i>Neisseria gonorrhoeae<\/i>: data from GToG"],"prefix":"10.1136","volume":"96","clinical-trial-number":[{"clinical-trial-number":"isrctn51783227","registry":"10.18810\/isrctn"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0737-0157","authenticated-orcid":false,"given":"Sarah","family":"Mensforth","sequence":"first","affiliation":[{"name":"Department of Sexual Health and HIV, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2097-8949","authenticated-orcid":false,"given":"Oluseyi Cyril","family":"Ayinde","sequence":"additional","affiliation":[{"name":"Department of Sexual Health and HIV, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Ross","sequence":"additional","affiliation":[{"name":"Department of Sexual Health and HIV, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,7,30]]},"reference":[{"key":"2025081306202249000_96.8.556.1","unstructured":"Fifer H , Saunders J , Soni S , et al . British Association for Sexual Health and HIV national guideline for the management of infection with Neisseria gonorrhoeae (2019), 2019. Available: https:\/\/www.bashhguidelines.org\/media\/1208\/gc-2019.pdf [Accessed 28 Jan 2019]."},{"key":"2025081306202249000_96.8.556.2","unstructured":"Mensforth S , Ross JDC . Assessing the Frequency of Spontaneous Clearance of Gonococcal Infection in the Absence of Antibiotic Therapy: a review of the literature The International Union Against Sexually Transmitted Infections Asia Pacific Conference 2018, New Zealand [November 2018]. Conference Poster presentation., 2018. Available: https:\/\/az659834.vo.msecnd.net\/eventsairaueprod\/production-ashm-public\/985872a73ea64df196772b80254c093f"},{"key":"2025081306202249000_96.8.556.3","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2015-052399"},{"key":"2025081306202249000_96.8.556.4","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0b013e3181b5f15d"},{"key":"2025081306202249000_96.8.556.5","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.1.6176.1462"},{"key":"2025081306202249000_96.8.556.6","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-104-5-655"},{"key":"2025081306202249000_96.8.556.7","doi-asserted-by":"crossref","first-page":"A97.4","DOI":"10.1136\/sextrans-2013-051184.0298","article-title":"P2.033\u2005Isolation of Neisseria Gonorrhoeae from the Tonsils and Posterior Oropharynx Using Culture","volume":"89","author":"Bissessor","year":"2013","journal-title":"Sex Transm Infect"},{"key":"2025081306202249000_96.8.556.8","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2017-053147"},{"key":"2025081306202249000_96.8.556.9","article-title":"Substantial natural clearance of genital and extragenital Chlamydia trachomatis and Neisseria gonorrhoeae in STD clinic attendees","volume":"89","author":"Van Liere","year":"2013","journal-title":"Sexually Transmitted Infections"},{"key":"2025081306202249000_96.8.556.10","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw141"},{"key":"2025081306202249000_96.8.556.11","article-title":"Feasibility study to determine the time taken for NAATs tests to become negative following treatment for Chlamydia trachomatis and Neisseria gonorrhoeae in men and women","volume":"92","author":"Sultan","year":"2016","journal-title":"Sexually Transmitted Infections"},{"key":"2025081306202249000_96.8.556.12","doi-asserted-by":"crossref","DOI":"10.1136\/sextrans-2015-052270.399","article-title":"P09.15\u2005Time to clearance for molecular test-of-cure among men treated for urethral, pharyngeal, or rectal gonorrhoea in san francisco,2013\u20132014","volume":"91","author":"Nguyen","year":"2015","journal-title":"Sex Transm Infect"},{"key":"2025081306202249000_96.8.556.13","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2018-053825"},{"key":"2025081306202249000_96.8.556.14","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2014-051633"},{"key":"2025081306202249000_96.8.556.15","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0b013e318151497d"},{"key":"2025081306202249000_96.8.556.16","doi-asserted-by":"crossref","first-page":"2511","DOI":"10.1016\/S0140-6736(18)32817-4","article-title":"Gentamicin compared with ceftriaxone for the treatment of gonorrhoea (G-ToG): a randomised non-inferiority trial","volume":"393","author":"Ross","year":"2019","journal-title":"Lancet"},{"key":"2025081306202249000_96.8.556.17","doi-asserted-by":"publisher","DOI":"10.1128\/IAI.67.8.3937-3946.1999"},{"key":"2025081306202249000_96.8.556.18","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0b013e3181ec51f1"},{"key":"2025081306202249000_96.8.556.19","doi-asserted-by":"publisher","DOI":"10.1258\/095646203321156872"},{"key":"2025081306202249000_96.8.556.20","doi-asserted-by":"publisher","DOI":"10.1258\/0956462053888925"},{"key":"2025081306202249000_96.8.556.21","doi-asserted-by":"publisher","DOI":"10.1155\/2010\/760218"},{"key":"2025081306202249000_96.8.556.22","doi-asserted-by":"publisher","DOI":"10.1086\/381895"},{"key":"2025081306202249000_96.8.556.23","unstructured":"Hook III EW , Ndowa F , Mabey D , et al . Choosing tests for sexually transmitted infections. In: Unemo M , ed. Laboratory diagnosis of sexually transmitted infections, including human immunodeficiency virus. Geneva: World Health Organisation, 2013: 1\u20138."},{"key":"2025081306202249000_96.8.556.24","unstructured":"Ivanov Z , Allen H , Sadouki Z , et al . Surveillance of antimicrobial resistance in Neisseria gonorrhoeae in England and Wales. key findings from the gonococcal resistance to antimicrobials surveillance programme (GRASP) London public health England, 2018. Available: https:\/\/assets.publishing.service.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/746261\/GRASP_2017_report.pdf[Accessed 28 Oct 2019]."},{"key":"2025081306202249000_96.8.556.25","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2013-051147"},{"key":"2025081306202249000_96.8.556.26","article-title":"O02.4\u2005Incidence and duration of pharyngeal and rectal gonorrhea and chlamydia among high-risk men who have sex with men (MSM)","volume":"95","author":"Barbee","year":"2019","journal-title":"Sexually Transmitted Infections"},{"key":"2025081306202249000_96.8.556.27","article-title":"United Kingdom national guideline on the sexual health care of men who have sex with men","volume":"2018","author":"Clutterbuck","year":"2016","journal-title":"Int J STD AIDS"}],"container-title":["Sexually Transmitted Infections"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/sextrans-2020-054500","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T13:21:23Z","timestamp":1755091283000},"score":1,"resource":{"primary":{"URL":"https:\/\/sti.bmj.com\/lookup\/doi\/10.1136\/sextrans-2020-054500"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7,30]]},"references-count":27,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2020,11,18]]},"published-print":{"date-parts":[[2020,12]]}},"alternative-id":["10.1136\/sextrans-2020-054500"],"URL":"https:\/\/doi.org\/10.1136\/sextrans-2020-054500","relation":{},"ISSN":["1368-4973","1472-3263"],"issn-type":[{"value":"1368-4973","type":"print"},{"value":"1472-3263","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,7,30]]}}}