A study of 'routine' gonorrhea cultures in a family practice.

A varying, but significant, incidence of "asymptomatic" gonorrhea in women has been reported by numerous investigators and is one rationale for collecting specimens during pelvic examinations for screening gonorrhea cultures. There is a lack of research evidence, however, to document the value of such cultures in all settings. In this retrospective study of gonorrhea cultures in a family practice, all of the cultures performed in one year were reviewed. Of the 219 clinically asymptomatic women who had screening cultures ordered, only two (0.9 percent) had culture-positive results, and both were known to be recent contacts of men with confirmed gonorrhea and hence would have had a screening culture ordered anyway. This finding opens to serious question the value of routinely screening women for gonorrhea by culturing vaginal specimens in all circumstances and suggests that thorough history and examination alone, supplemented by cultures only when clinically indicated, would suffice in certain settings.