Treatment of Gonorrhoea in Pregnancy and During Breast/Chest-Feeding
Treating gonorrhoea in individuals who are pregnant or breast/chest-feeding requires careful antibiotic selection. Several agents used in the general population are contraindicated in this group, making the choice of regimen more constrained than standard care.
This protocol applies to individuals with gonorrhoea who are pregnant or breast/chest-feeding. The safety profile of antimicrobials in relation to the pregnancy and the feeding infant must guide all prescribing decisions.
Pregnant and breast/chest-feeding individuals should not be treated with quinolones. Gentamicin should also be avoided during pregnancy. These exclusions narrow the available options compared with non-pregnant patients.
Management involves a specific injectable antibiotic as the first-line choice, given as a single administration. An oral alternative pathway exists for cases where injection is not feasible, with susceptibility-dependent considerations for any additional agents.
Full regimen details, eligibility criteria, and alternative sequencing are in the structured protocol below.References
DOI: 10.1177/09564624251345195
- Ceftriaxone 1 g intramuscularly (IM) as a single dose (GRADE 1B).
- Pregnant and breast/chest-feeding individuals should not be treated with quinolones.
- Gentamicin should be avoided in pregnancy.
- In addition, azithromycin should only be used if the isolate is known to be susceptible.