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gonorrhoea

Content version
U-235.2
Updated
10/20/2025 - 12:48

Recommendations

≥ 18 years
Dosage Remarks
ceftriaxone intramuscular 500 mg single dose

SWAB remarks

urethral/anal gonorrhoea
≥ 18 years

Indications: pregnancy, lactation
Dosage Remarks
1st choice
ceftriaxone intramuscular 500 mg single dose
1st choice alternative
amoxicillin oral 3000 mg single dose

SWAB remarks

if ceftriaxone is contraindicated; guided by resistance pattern
≥ 18 years

Indications: strong suspicion of or proven cephalosporin allergy or a previous severe 'delayed-type' allergy to a β-lactam antibiotic
Dosage Remarks
ciprofloxacin oral 500 mg single dose

SWAB remarks

only if susceptibility to ciprofloxacin is proven
azithromycin oral 2000 mg single dose

SWAB remarks

follow-up required

Comments

500 and 1000 mg ceftriaxone respectively dissolved in 2 ml and 3.5 ml lidocaine hydrochloride 10 mg/ml (1%) solution (pain prevention)

If ceftriaxone is not available, a good alternative is: cefotaxime 1000 mg intramuscular, single dose. Only if susceptibility is proven: ciprofloxacin 500 mg oral, single dose.

In cases of high clinical suspicion of gonococcal conjunctivitis (severe and acute purulent presentation) the patient should urgently (the same day) be seen by an ophthalmologist for microbiological diagnostics, treatment and to exclude gonococcal keratitis.

Disseminated infection: ceftriaxone IV 2000 mg once daily for 7 days; if susceptibility proven, after 3 days switch to ciprofloxacin oral 500 mg twice daily for 7 days

For treatment of gonococcal conjunctivitis, see 2.1 Conjunctivitis - unknown pathogen

For treatment of gonococcal arthritis, see 3.6 Septic arthritis - gonococci (Neisseria gonorrhoeae)