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Gonorrhea: Treatment and Prevention

Overview

Gonorrhea is a sexually transmitted infection (STI) caused by the Neisseria gonorrhoeae bacterium. The infection is passed from person-to-person through unprotected vaginal, anal, or oral sex. It can affect the penis, vagina, or throat, among other areas of the body. According to Planned Parenthood, more than 800,000 Americans are diagnosed with gonorrhea each year.

Gonorrhea can lead to serious complications when left untreated, so it’s important to receive treatment as soon as possible. Most cases of gonorrhea can be treated effectively with the correct medications. The infection can even be cured if treatment is received promptly. People who have been recently diagnosed with gonorrhea should also get tested for other STIs, including syphilis, chlamydia, herpes, HPV (human papillomavirus), and HIV (human immunodeficiency virus).

How Is Gonorrhea Treated?

Treatment

Antibiotics can effectively relieve symptoms and may cure gonorrhea infections, as long as the medications are taken as prescribed. Treatment will begin as soon as the diagnosis is made.

Treating Genital Gonorrhea

The following medications are usually given to non-pregnant women with gonorrhea infections affecting the cervix, urethra, or rectum:

  • cefixime (Suprax), 400 milligram (mg) taken orally
  • ceftriaxone (Rocephin), 125 mg injected into a muscle as a single dose
  • ciprofloxacin (Cipro), 500 mg taken orally
  • ofloxacin (Floxin), 400 mg taken orally as a single dose
  • spectinomycin (Trobicin), 2 grams injected into a muscle in a single dose

Treating Oral Gonorrhea

Gonorrhea infections that affect the throat are more difficult to treat than those that affect the genital area. Although the same medications are recommended for treating oral gonorrhea infections, they tend to be less effective. A doctor may perform a throat culture five to seven days after treatment begins. This can help them determine whether the infection is gone. Prolonged treatment will be needed if the infection doesn’t go away within a few days.

Treating Disseminated Gonorrhea

Disseminated gonorrhea occurs when the Neisseria gonorrhoeae bacterium infects the bloodstream. People need to be hospitalized during the first phase of treatment for this type of gonorrhea. Initial treatment often consists of a medication called ceftriaxone. Every day, approximately1 gram of ceftriaxone will be given intravenously ( through an IV).

If you have disseminated gonorrhea but are allergic to ceftriaxone, your treatment will likely begin with:

  • intravenous ciprofloxacin, 500 mg
  • intravenous ofloxacin, 400 mg
  • intramuscular spectinomycin, 2 grams every 12 hours

The first phase continues until the condition has shown signs of improvement for at least 24 to 48 hours. During the second phase, one of the following medications will need to be taken for at least one week:

  • cefixime, 400 mg taken twice per day
  • ciprofloxacin, 500 mg taken twice per day
  • ofloxacin, 400 mg taken twice per day

Treating Conjunctivitis

In rare cases, gonorrhea may lead to the development of conjunctivitis. Conjunctivitis, commonly known as pink eye, is an infection that causes swelling around the eyes. Blood vessels within the outer lining of the eye become inflamed, giving the eye a red or pink color. When conjunctivitis occurs as a result of a gonorrhea infection, the recommended treatment is ceftriaxone. One gram will be injected into a muscle. The affected eye will also need to be washed thoroughly with a saline solution.

Is Treatment Different for Pregnant Women with Gonorrhea?

pregnant women

The treatment for gonorrhea in pregnant women is essentially the same as the treatment for non-pregnant women. The only exception is that quinolone antibiotics, such as ciprofloxacin and ofloxacin, aren’t given to women who are pregnant. These antibiotics can inhibit DNA formation and cause birth defects.

Pregnant women who are allergic to ceftriaxone or cefixime will be given 2 grams of spectinomycin in a single injection.

Pregnant women who are diagnosed with gonorrhea should be tested for other sexually transmitted infections (STIs) as well.

What Are the Possible Side Effects of Treatment for Gonorrhea?

Complications

In recent years, the Neisseria gonorrhea bacterium has become resistant to some of the drugs used to treat gonorrhea, including penicillin and the tetracyclines. This means that the medications are less effective in treating and curing the infection. These cases require extensive treatment or a combination of antibiotics. However, researchers publishing in the Journal of Antimicrobial Chemotherapy, believe the bacterium may eventually build a resistance to more of the drugs used to treat gonorrhea.

The side effects of certain medications are another concern regarding antibiotic therapy. All of the recommended antibiotic medications can cause changes in the bacteria that normally inhabit the bowel or vagina. This may make women more susceptible to diarrhea or vaginal yeast infections. Gastrointestinal upset is another common side effect of antibiotics.

Other possible side effects vary depending on the type of antibiotic being used to treat gonorrhea.

  • Ceftriaxone and cefixime can trigger severe allergic reactions.
  • Cephalosporin antibiotics, such as ceftriaxone and cefixime, may cause kidney damage.
  • Quinolone antibiotics, such as ciprofloxacin and ofloxacin, have been linked to problems in the nervous system. These include headaches, dizziness, and convulsions as a result of increased pressure within the brain. Due to the risks associated with quinolone antibiotics, they are never given to pregnant women.
  • Spectinomycin may cause nausea and dizziness, but this is fairly rare.

How Can Gonorrhea Be Prevented?

Prevention

It’s important to take certain precautions to help prevent the spread of gonorrhea. There are also preventive measures that can keep the infection from happening in the first place.

The most reliable way to prevent gonorrhea is to:

  • abstain from sexual intercourse
  • use a reliable condom every time you have vaginal, oral, or anal sexual intercourse
  • have only one sexual partner who is uninfected and who is also sexually monogamous

Since gonorrhea usually doesn’t cause symptoms, it’s important to get tested regularly, especially if your partner has been diagnosed with gonorrhea. Speak with your doctor about how often you should be tested for gonorrhea and other STIs.

Preventing the Spread of Gonorrhea

To minimize the risk of transmitting gonorrhea to others, you should avoid having sexual intercourse for at least seven days after completion of treatment. You should also encourage anyone you’ve had sexual intercourse with over the past 60 days to see their own doctors for evaluation.

If you’re in a romantic relationship, your partner should get tested for gonorrhea. Even if you are treated for gonorrhea, you can still get re-infected from your partner. Your partner will receive the same treatment as you if they have the infection. You and your partner will need to abstain from sexual intercourse until you’ve both completed treatment and are cured. 

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