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Treatment of uncomplicated gonococcal infections

Heidi Swygard, MD, MPH
Arlene C Seña, MD, MPH
Myron S Cohen, MD
Section Editor
Noreen A Hynes, MD, MPH, DTM&H
Deputy Editor
Allyson Bloom, MD


Gonococcal infections, including urethritis, cervicitis, epididymitis, and proctitis, are a significant cause of morbidity among sexually active men and women. The treatment of these sexually transmitted infections (STIs) has evolved over the years, mainly due to the emergence of antibiotic resistance.

Urogenital, anogenital, pharyngeal, and ocular gonococcal infections that are not associated with bacteremic or ascending spread of the pathogen to other organs are considered uncomplicated. This topic will address the treatment of these gonococcal infections, with a focus on urogenital infections. The discussion in this topic is largely consistent with the 2015 sexually transmitted disease (STD) treatment guidelines from the United States Centers for Disease Control and Prevention [1].

The clinical manifestations and diagnosis of gonorrhea are discussed elsewhere. The treatment of complicated infections, such as disseminated gonococcal infection and pelvic inflammatory disease, is found elsewhere. (See "Epidemiology and pathogenesis of Neisseria gonorrhoeae infection" and "Cutaneous manifestations of gonorrhea" and "Clinical manifestations and diagnosis of Neisseria gonorrhoeae infection in adults and adolescents" and "Disseminated gonococcal infection" and "Pelvic inflammatory disease: Treatment", section on 'Recommended regimens'.)


Therapeutic principles — It is desirable for a therapeutic gonococcal regimen to:

Be highly effective at all anatomic sites of infection

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Literature review current through: Oct 2017. | This topic last updated: Jul 10, 2017.
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