General principles of management: 1. accurate diagnosis, 2. effective treatment, 3. careful follow-up, 4. contact tracing and 5 sexual abstinence. Treatment failure: Treatment failure is considered when there is reappearance of gonococci 14 days after treatment in a patient who denies fresh contact. Treatment failure: 1. penicillin resistance—partial, total, 2. associated non-gonococcal infection, and 3. chronic infection and sequelae. Penicillin resistance (PPNG strain): (a) spectinomycin 2 gm IM, (b) Cephalosporin injection cefoxitin 2 gm IM, (c) Cefotaxime: 1 gm IM (Single dose).