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Pages in this Section. Gonococcal Infections Among Adolescents and Adults. Gonococcal Infections Among Neonates. Gonococcal Infections Among Infants and Children. Next. Last Reviewed: July 22, 2021.
This update provides the rationale for the change in gonorrhea treatment recommendations to a higher dose (500 mg) of ceftriaxone and removal of azithromycin from the recommended regimen.
At present, the only CDC-recommended treatment of uncomplicated urogenital, anorectal, and pharyngeal gonorrhea is monotherapy with a single intramuscular dose of ceftriaxone 500 mg.
Empiric treatment of urethritis and cervicitis comprises regimens effective against gonorrhea and chlamydia. Trichomoniasis may also cause persistent infection in women or heterosexual men.
The treatment of these sexually transmitted infections (STIs) has evolved over the years, mainly due to the emergence of antibiotic resistance. This topic will address the treatment of these gonococcal infections, with a focus on urogenital infections.
The 2019 CDC STD Surveillance Report found that the annual cases of STIs in the US continued to increase in 2019, totaling more than an estimated 2.5 million cases of chlamydia, gonorrhea, and syphilis; congenital syphilis increased by 279% between 2015 and 2019.
The recommended treatment for gonorrhea is ceftriaxone monotherapy given intramuscularly, with dosing based on the patient’s body weight. For chlamydia, doxycycline is the preferred treatment.
Pregnant patients diagnosed with chlamydia or gonorrhea should have a test of cure four weeks after treatment.
To minimize disease transmission, persons treated for gonorrhea should be instructed to abstain from sexual activity for 7 days after treatment and until all sex partners are treated (7 days after receiving treatment and resolution of symptoms, if present).
These guidelines provide recommendations for treatment of gonorrhoea, chlamydia and syphilis based on the best available evidence at the time of compilation. However, the epidemiology and the patterns of AMR vary geographically and need to be monitored, in particular for N. gonorrhoeae .