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How is Gonorrhea Treated?

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Updated May 23, 2014

Woman doctor giving patient injection
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Question: How is Gonorrhea Treated?
Answer:

Gonorrhea is treated with antibiotics. Because patients with gonorrhea frequently also have chlamydia, they are often treated presumptively for both diseases just on the basis of a single diagnosis (for more on chlamydia treatment click here.)

In recent years, drug resistant gonorrhea has become more problematic, both in the United States and worldwide. In April 12, 2007, the CDC removed numerous drugs from their treatment recommendations because they are no longer considered to be effective. At that point, there was only one class of drugs considered to be effective in the treatment of gonorrhea.

In the summer of 2012, the CDC updated the guidelines again - recommending that all gonorrhea cases be treated with injectable, rather than oral, antibiotics. That said, if your doctor does prescribe an oral regimen, it is essential that you take them as written, and finish your prescription even if you feel better. This reduces the risk of your infection developing resistance. As things stand, gonorrhea is well on its way to becoming an incurable disease.

Treatment for gonorrhea differs depending on whether gonorrhea is present in the genitals or in the throat. Throat infections with gonorrhea are more difficult to treat and may require more extensive treatment. Infections that have spread beyond the primary site of infection causing, for example, pelvic inflammatory disease or epididymitis, may also require more intense treatment.

When you are being treated for gonorrhea it is important that your sexual partners are treated as well. If they are not, you could end up passing the infection back and forth between you. You should also abstain from sex until your symptoms clear up, and for at least 7 days after the start of treatment, in order not to infect your sexual partners. If abstaining is not possible, make certain to use condoms for all sexual encounters - including oral sex.

Because people who are infected with gonorrhea once are likely to become infected again, many doctors recommend that patients with a gonorrhea diagnosis return 3 months later for a check up. This is not only because treatment may have been ineffective, it is also to make certain that you have not been re-infected by your partners.

The drug regimens below are taken from the the Centers for Disease Control 2012 gonorrhea treatment update. Remember that only your doctor can say which treatment is right for you.

Recommended Regimens for Adults With Genital & Rectal Infections

Ceftriaxone 125 mg injected into the muscle in a single dose
PLUS
Azithromycin 1 g orally in a single dose (preferred) or doxycycline 100 mg orally twice daily for 7 days*

Alternative Regimens

Cefixime 400 mg in a single oral dose
PLUS
Azithromycin 1 g orally in a single dose (preferred) or doxycycline 100 mg orally twice daily for 7 days*
PLUS
Test-of-cure in 1 week

If the patient has severe cephalosporin allergy:

Azithromycin 2 g in a single oral dose

Recommended Regimens for Adults With Throat Infections

Ceftriaxone 125 mg injected into the muscle in a single dose
PLUS
Azithromycin 1 g orally in a single dose (preferred) or doxycycline 100 mg orally twice daily for 7 days*


Notes:
  • Pregnant women with gonorrhea should not be treated with tetracyclines. For more about gonorrhea during pregnancy click here.
  • Azithromycin is preferable to doxycycline for the supplementary antibiotic, because there have been a growing number of tetracycline resistant gonorrhea infections seen both in the United States and around the world.

Source:
CDC (2012, August 10) Update to CDC's Sexually Transmitted Diseases Treatment Guidelines, 2010: Oral Cephalosporins No Longer a Recommended Treatment for Gonococcal Infections. Morbidity and Mortality Weekly Reports 61(31);590-594

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