Gonococcal Conjunctivitis in Adults and Adolescents with Cephalosporin Allergy

Gonococcal conjunctivitis demands prompt systemic antibiotic treatment. In adults and adolescents who carry a cephalosporin allergy, the usual first-choice class of antibiotics is contraindicated, and an alternative regimen must be used.

⚠ Cephalosporin allergy present: This protocol is specific to patients for whom cephalosporin antibiotics cannot be used, requiring a tailored alternative approach to cover gonococcal infection.

Treatment approach

Management calls for a single-dose combination antibiotic regimen — one agent administered orally and one by intramuscular injection — chosen to provide adequate gonococcal coverage without using cephalosporins.

Full agents, doses, and administration details are in the complete protocol.

Clinical goal

Resolution of the conjunctivitis, with clinical assessment performed daily until the episode resolves.

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References

For cephalosporin-allergic patients:
Azithromycin 2 g orally, single dose
Gentamicin 240 mg IM, single dose
Patients with gonococcal conjunctivitis should be seen daily until resolution of the conjunctivitis.

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