• The treatment recommendations for gonorrhea have changed substantially during the past 5 years.
  • Because of a high rate of antimicrobial resistance, fluoroquinolones are no longer recommended to treat gonorrhea.
  • To treat a potential coinfection with chlamydia, the treatment regimen for gonorrhea should include either a single dose of azithromycin or 1 week of doxycycline, even if testing for Chlamydia trachomatis is negative at the time of treatment.
  • The mainstays of treatment for gonorrhea have been intramuscular ceftriaxone or oral cefixime.
  • However, there is concern regarding the susceptibility of Neisseria gonorrhoeae to cefixime.
  • The CDC now recommends that gonorrhea be treated with ceftriaxone 250 mg intramuscularly in a single dose, not with cefixime. Ceftriaxone should be combined with azithromycin 1 g once only or doxycycline 100 mg twice daily for 7 days.