How is gonococcal urethritis treated?

Updated: Dec 12, 2018
  • Author: Martha K Terris, MD, FACS; Chief Editor: Edward David Kim, MD, FACS  more...
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Answer

For uncomplicated gonococcal urethritis, the CDC recommends single doses of ceftriaxone, 250 mg IM, and azithromycin, 1 g orally; preferably, the two antibiotics should be administered simultaneously and under direct observation. If ceftriaxone is unavailable, cefixime, 400 mg orally in a single dose, can be substituted. [8]

Gonorrhea treatment guidelines issued by the World Health Organization (WHO) in 2016 recommend determining the choice of therapy on the basis of local antibiotic resistance data, but in settings where local resistance data are not available, the WHO recommends the same dual-therapy regimens as the CDC for treatment of genital gonorrhea. [11]

Because of widespread high levels of resistance, the WHO guidelines do not recommend quinolones for the treatment of gonorrhea. For monotherapy of genital gonorrhea, the WHO guidelines recommend a single dose of one of the following, with the choice based on recent local resistance data confirming susceptibility [11] :

  • Ceftriaxone 250 mg IM
  • Cefixime 400 mg orally
  • Spectinomycin 2 g IM

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