All the tools for controlling gonorrhea are available in developed countries. Sensitive and specific culture media and direct microscopy are available for making accurate diagnoses. Antibiotic susceptibility testing can determine appropriate drug therapy. National guidelines recommend a range of highly effective, single-dose antibiotics to which Neisseria gonorrhoeae is susceptible. Contact tracing can be initiated so that sexual partners are notified and onward transmission is interrupted. Condoms to prevent the acquisition or transmission of gonorrhea are widely available. Nationwide systems of surveillance exist to follow epidemiologic trends in the rate of disease and to monitor the emergence of antibiotic resistance in a timely fashion.

Despite all this, the prospect of eradicating gonorrhea is remote. In the United States in 1994, it was estimated that approximately 800,000 new gonococcal infections are diagnosed every year.<sup>17 The Hidden Epidemic: Confronting Sexually Transmitted Diseases Washington, DC: National Academy Press (1997). 

Cliccare qui per andare alla sezione Riferimenti</sup> The direct costs of these infections and their associated complications are approximately $900 million every year.<sup>17 The Hidden Epidemic: Confronting Sexually Transmitted Diseases Washington, DC: National Academy Press (1997). 

Cliccare qui per andare alla sezione Riferimenti</sup> This article examines the many links in the chain of management of individual cases of gonorrhea and where they may fail. Factors influencing gonorrhea control at the population level and their implications for prevention programs are then discussed.