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Uncomplicated Gonococcal Infection - Antibiotic Management
Both locally and nationally, resistance in gonococcal isolates has meant that both the penicillin and quinolone antibiotics can no longer be relied upon for empirical treatment of gonococcal disease. Intramuscular ceftriaxone is now the standard treatment for infections where sensitivity results are unknown. 1st line Ceftriaxone 250mg IM stat or Cefixime 400mg PO stat if IM route contraindicated (unlicensed indication)
or if known ciprofloxacin sensitive strain and not pregnant or breastfeeding: Ciprofloxacin 500mg orally stat. As ciprofloxacin can increase selection for C.difficile infection and MRSA colonisation/infection, all patients with previous MRSA/C.difficile require microbiology approval to use ciprofloxacin. Adjust antibiotics according to culture and sensitivity results only if no improvement, and after discussion with microbiology (in view of rising resistance in gonococcal isolates). The Full Guideline "Antibiotic Guideline for Acute Pelvic Inflammatory Disease" is available here. |
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Caution; the antibiotic doses recommended on this website are intended for adult patients with normal renal and liver function unless otherwise stated. Dosing advice for patients with renal impairment is available here. |