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Gonorrhea
Gonorrhea causes urethral, cervical, rectal, or pharyngeal infections.
Indications for Immediate Empiric Treatment
Mucopurulent cervicitis
Pelvic inflammatory disease
Contacts of persons with gonococcal infection or to presumptive gonococcal infection
Treatment of partners should be provided
Diagnostic Labs
Culture is recommended for public health purposes.
Test of cure is not necessary.
Serologic testing for syphilis and HIV should be considered.
Treatment of Uncomplicated Infections
Ceftriaxone (Rocephin) 250 mg IM; active against incubating syphilis OR
Cefixime (Suprax) 400 mg po; active against incubating syphilis OR
Ciprofloxacin (Cipro) 500 mg po; contraindicated <17 years of age; not active against syphilis OR
Ofloxacin (Floxin) 400 mg po; contraindicated <17 years of age; not active against syphilis.
Doxycycline 100 mg po bid x 7 days; for coexisting Chlamydia trachomatis infection; may abort incubating syphilis.
Alternative Regimens
Ceftizoxime 500 mg IM, cefotaxime 500 mg sexually transmitted diseases cefotetan 1 g IM, cefoxitin 2 g IM, cefuroxime axetil (Ceftin) 1 g po, cefpodoxime 200 mg po.
Enoxacin 400 mg po, lomefloxacin 400 mg po, or norfloxacin 800 mg po
Doxycycline 100 mg po bid x 7d. Sexually Transmitted Diseases, std, stds
Chlamydia Trachomatis
Chlamydia may cause urethritis, STD, STDs, stds cervicitis, conjunctivitis, or proctitis, clamidia.
Diagnostic Labs
Antigen testing is more rapid than culture for chlamydia.
Test of cure is not necessary if a recommended regimen was used.
Serologic testing for clamidia