Gonorrhoea diagnoses are on the increase in England and a cluster of high-level azithromycin resistance was detected in 2015.1,2 Treatment options are limited and, in response to emerging antimicrobial resistance, treatment guidelines have changed twice since 2004.3,4 Current recommended treatment for gonorrhoea is dual therapy with 500 mg ceftriaxone (intramuscularly) and 1 g azithromycin (orally).3 Following a diagnosis of gonorrhoea in general practice, referral to …