What Is the First-Line Treatment of Gonorrhoea?
Gonorrhoea is a bacterial sexually transmitted infection requiring prompt antibiotic treatment. Current evidence-based guidance specifies a primary regimen and a set of alternatives for patients who cannot receive the standard approach.
Treatment Approach
First-line management centres on a single-dose injectable antibiotic. Where the standard route is not appropriate — due to allergy, needle phobia, or other contraindications — the protocol includes several alternative antibiotic regimens, including oral options. The complete selection criteria, regimen details, and decision points are available in the full protocol.
References
DOI: 10.1177/09564624251345195
- Ceftriaxone 1 g intramuscularly (IM) as a single dose (GRADE 1B).
- Alternative regimens may be given because of allergy, needle phobia or other absolute or relative contraindications.
- Cefixime 400 mg orally followed by another 400 mg dose 6–12 h later; plus azithromycin 2 g orally (which may be divided as two 1 g doses 6–12 h apart) should also be given (GRADE 1B).
- Gentamicin 240 mg IM as a single dose plus azithromycin 2 g orally (GRADE 1A).
- Azithromycin 2 g as a single oral dose (GRADE 1B).
- Ciprofloxacin 500 mg orally as a single dose (GRADE 1B).
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