![]() ![]() Uncomplicated urethral, cervical, or rectal gonococcal infectionĬeftriaxone (Rocephin), 250 mg IM in a single doseĪzithromycin (Zithromax), 1 g orally in a single dose, or doxycycline, 100 mg orally twice per day for 7 days * If urethritis still persists, consider chronic nonbacterial prostatitis or chronic pelvic pain syndrome If urethritis persists after treatment, consider doxycycline-resistant Ureaplasma urealyticum or M. trachomatis infection (15 to 40 percent)Įnteric bacteria (associated with insertive anal intercourse) The USPSTF recommends high-intensity behavioral counseling to prevent sexually transmitted infections in all sexually active adolescents and in adults at increased risk.įrequent douching or exposure to another irritantĬ. The CDC recommends that all men who have sex with men and practice receptive anal or oral intercourse be screened at least annually for rectal or pharyngeal gonococcal infection with a rectal or pharyngeal nucleic acid amplification swab test. The CDC recommends that all men who have sex with men and practice insertive anal intercourse be screened at least annually for urethral gonococcal infection with a urine nucleic acid amplification test. The USPSTF recommends against routine screening for gonorrhea in men and women who are at low risk of infection. The USPSTF recommends routine screening for gonorrhea in all sexually active women if they are at increased risk of infection, including those who are pregnant. Retesting for gonococcal infection is recommended three to six months after treatment in men and women to detect reinfection, regardless of partner treatment. Uncomplicated gonococcal infections of the cervix, urethra, rectum, or pharynx should be treated with a single dose of ceftriaxone (Rocephin), 250 mg intramuscularly, and either azithromycin (Zithromax), 1 g orally, or doxycycline, 100 mg orally twice daily for seven days. The USPSTF recommends that all newborns receive ocular topical medication for prophylaxis against gonococcal ophthalmia neonatorum.įluoroquinolones should not be used to treat gonorrhea in the United States because of the emergence of quinolone-resistant Neisseria gonorrhoeae. ![]() Condom use is an effective strategy to reduce the risk of infection. It also recommends intensive behavioral counseling for persons with or at increased risk of contracting sexually transmitted infections. Preventive Services Task Force recommends screening for gonorrhea in all sexually active women at increased risk of infection. Because of high reinfection rates, patients should be retested in three to six months. Gonococcal infection should prompt physicians to test for other sexually transmitted infections, including human immunodeficiency virus. Azithromycin may be used as an alternative treatment option for patients with previous allergic reactions to penicillin, but because of the likelihood of antimicrobial resistance, its use should be limited. This dosage is more effective for common pharyngeal infections than the previously recommended dose of 125 mg. First-line treatment for uncomplicated urogenital, anorectal, or pharyngeal gonococcal infections is a single intramuscular injection of ceftriaxone, 250 mg, accompanied by either azithromycin, 1 g orally, or doxycycline, 100 mg orally twice daily for seven days, to prevent bacterial resistance and address the likelihood of coinfection with Chlamydia trachomatis. Fluoroquinolones are no longer recommended for the treatment of gonorrhea because of antimicrobial resistance. Urine nucleic acid amplification tests have a sensitivity and specificity comparable to those of cervical and urethral samples. gonorrhoeae infection can be diagnosed using culture or nucleic acid amplification testing. If left untreated, gonorrhea may cause pelvic inflammatory disease in women, or it may disseminate, causing synovial and skin manifestations. Neonatal infections include conjunctivitis and scalp abscesses. Men with gonorrhea may present with penile discharge and dysuria, whereas women may present with mucopurulent discharge or pelvic pain however, women often are asymptomatic. ![]() Urogenital tract infections are most common. Neisseria gonorrhoeae causes urogenital, anorectal, conjunctival, and pharyngeal infections. ![]()
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