Gonorrhea / Adolescents and Adults

Ceftriaxone 500 mg* IM in a single dose for persons weighing <150kg 

If chlamydial infection has not been excluded, treat for chlamydia with doxycycline 100 mg orally 2 times/day for 7 days. 

* For persons weighing ≥150 kg, 1 g ceftriaxone should be administered.

Gentamicin 240 mg IM in a single dose  

PLUS  

Azithromycin 2 g orally in a single dose 

OR  

Cefixime* 800 mg orally in a single dose 

* If chlamydial infection has not been excluded, providers should treat for chlamydia with doxycycline 100 mg orally 2 times/day for 7 days. 

Ceftriaxone 500 mg* IM in a single dose for persons weighing <150kg 

If chlamydial infection is identified when pharyngeal gonorrhea testing  is performed, treat for chlamydia with doxycycline 100 mg orally 2 times/day for 7 days. 

* For persons weighing ≥150 kg, 1 g ceftriaxone should be administered. 

Any person with pharyngeal gonorrhea should return 7–14 days after initial treatment for a test of cure by using either culture or NAAT; however, testing at 7 days might result in an increased likelihood of false-positive tests. If the NAAT is positive, effort should be made to perform a confirmatory culture before retreatment, especially if a culture was not already collected. All positive cultures for test of cure should undergo antimicrobial susceptibility testing. 

No reliable alternative treatments are available for pharyngeal gonorrhea. For persons with an anaphylactic or other severe reaction (e.g., Stevens Johnson syndrome) to ceftriaxone, consult an infectious disease specialist for an alternative treatment recommendation. 

Ceftriaxone 1 g IM in a single dose  

Providers should consider one-time lavage of the infected eye with saline solution.

None