What are pharmacologic treatment options for gonorrhea?

Updated: Sep 07, 2018
  • Author: Brian Wong, MD; Chief Editor: Pranatharthi Haran Chandrasekar, MBBS, MD  more...
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Because of resistance with oral cephalosporins, only 1 regimen, dual treatment with ceftriaxone and azithromycin, is recommended for treatment of gonorrhea in the United States. Dual therapy with ceftriaxone and azithromycin should be administered together on the same day, preferably simultaneously and under direct observation. In addition, persons infected with N gonorrhoeae frequently are coinfected with C trachomatis; this finding has led to the longstanding recommendation that persons treated for gonococcal infection also be treated with a regimen that is effective against uncomplicated genital C trachomatis infection, further supporting the use of dual therapy that includes azithromycin. [1]

Combination with azithromycin, versus doxycycline, is preferred because of the more convenient dosing, likely better patient compliance, and reports of increasing resistance to tetracyclines in some Gonococcal Isolate Surveillance Project (GISP) samples.

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