The Medications Used to Treat Gonorrhea

Azithromycin is among the better options for treatment

Doctor explaining prescription medication to patient in clinic
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In the United States, an estimated 820,000 new gonorrhea infections occur each year, according to the Centers for Disease Control and Prevention. Gonorrhea, a sexually transmitted disease, is the second most commonly reported communicable disease. 

Gonorrhea is commonly treated with antibiotics. Because people with gonorrhea frequently also have chlamydia, they are often treated presumptively for both diseases just on the basis of a single diagnosis.

Drug-resistant gonorrhea has become more problematic, both in the United States and worldwide. Gonorrhea has become resistant to most antimicrobials. The CDC has removed numerous drugs from treatment recommendations because they are no longer considered to be effective. 

In 2012, the CDC updated its guidelines recommending that all gonorrhea cases be treated with injectable, rather than oral, antibiotics. That said, if your doctor prefers to 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.

Gonorrhea Treatment Issues

Untreated gonorrhea can cause serious and permanent health problems in both women and men. 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 can spread beyond the primary site of infection and can cause pelvic inflammatory disease or epididymitis problems and 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 patients with a gonorrhea diagnosis return three 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 reinfected by your partners.

Drug Regimens for Gonorrhea

The drug regimens below are from the Centers for Disease Control and Prevention's 2015 Sexually Transmitted Disease Treatment Guidelines: Gonococcal Infections. Only your doctor can say which treatment is right for you. Special note, pregnant women with gonorrhea should not be treated with tetracyclines.

UsageTherapy for Gonococcal Infections
Uncomplicated gonococcal infection

Ceftriaxone 125 mg injected into the muscle in a single dose,

Azithromycin 1 g orally in a single dose

Alternative regimen

Cefixime 400 mg in a single oral dose,

Azithromycin 1 g orally in a single dose,

and test of cure in one week

Cephalosporin allergy

Single doses of oral gemifloxacin 320 mg and oral azithromycin 2 g, or

Dual treatment with single doses of intramuscular gentamicin 240 mg and oral azithromycin 2 g 

Adults with throat infections

Ceftriaxone 125 mg injected into the muscle in a single dose,

Azithromycin 1 g orally in a single dose

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