How is gonorrhea treated?

Gonorrhea is a common sexually transmitted infection that requires effective treatment to prevent complications and the spread of the disease. The treatment of gonorrhea has evolved due to the emergence of antibiotic-resistant strains of Neisseria gonorrhoeae.

Key insights from the research papers:

Ceftriaxone is the cornerstone of gonorrhea treatment, but alternative combinations such as gentamicin plus azithromycin and gemifloxacin plus azithromycin show high efficacy, especially for patients with cephalosporin allergy or suspected cephalosporin-resistant infections.
Azithromycin and ceftriaxone are the most effective antibiotics for treating gonorrhea, with current guidelines recommending their combined use. Gentamicin and ofloxacin are potential alternatives for drug-resistant gonorrhea.
Injectable ceftriaxone monotherapy and dual therapy with ceftriaxone combined with azithromycin or doxycycline show no treatment failures, contrasting with higher failure rates for oral cefixime monotherapy.
Dual therapy with ceftriaxone and azithromycin is the only recommended first-line regimen for gonorrhea treatment in the United States, with administration on the same day and under direct observation .
High provider adherence to CDC gonorrhea treatment recommendations, particularly in specialty STD clinics, has been documented, with the majority of patients receiving the recommended regimen of ceftriaxone plus azithromycin.

In conclusion, the most effective treatment for gonorrhea involves a combination of ceftriaxone and azithromycin, which is the recommended first-line regimen. Alternative treatments are available for cases involving cephalosporin resistance or allergy. High adherence to treatment guidelines is crucial for managing the disease and preventing the spread of resistant strains.

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How is gonorrhea treated?

Summary

Sources and full results

The efficacy and safety of gentamicin plus azithromycin and gemifloxacin plus azithromycin as treatment of uncomplicated gonorrhea.

Gentamicin/azithromycin and gemifloxacin/azithromycin are highly effective for treating urogenital gonorrhea, but gastrointestinal adverse events may limit routine use.

Efficacy and Safety of Injectable and Oral Antibiotics in Treating Gonorrhea: A Systematic Review and Network Meta-Analysis

Azithromycin and ceftriaxone are the most effective antibiotics for treating gonorrhea, with gentamicin and ofloxacin as potential alternatives for drug-resistant gonorrhea.

Gonorrhea Treatment Failures With Oral and Injectable Expanded Spectrum Cephalosporin Monotherapy vs Dual Therapy at 4 Canadian Sexually Transmitted Infection Clinics, 2010–2013

Combination treatment with extended-spectrum cephalosporins and azithromycin or doxycycline effectively prevents gonorrhea treatment failures, supporting their use in sexually transmitted infection clinics.

Committee Opinion No. 645: Dual Therapy for Gonococcal Infections.

Dual therapy with ceftriaxone and azithromycin remains the recommended first-line regimen for treating gonorrhea in the United States, with pregnant women advised to receive the treatment.

Adherence to CDC Recommendations for the Treatment of Uncomplicated Gonorrhea — STD Surveillance Network, United States, 2016

In 2016, 81% of reported gonorrhea patients received the CDC-recommended regimen for treatment, with high provider adherence in specialty STD clinics.

Committee Opinion No. 645: Dual Therapy for Gonococcal Infections.

Dual therapy with ceftriaxone and azithromycin remains the recommended first-line regimen for treating gonorrhea in the United States, with pregnant women advised to receive the recommended treatment.

Treatment of uncomplicated gonorrhea with cefotaxime.

Cefotaxime and APPG plus probenecid are comparable for treating uncomplicated genital and rectal infections with beta-lactamase-negative N. gonorrhoeae, with cefotaxime being better tolerated due to only one injection.

Treatment of Uncomplicated Gonorrhea with Ceftriaxone: A Review

Ceftriaxone (125 mg) is an effective and more effective treatment for uncomplicated gonorrhea than penicillin G, particularly when penicillinase-producing or chromosomally mediated resistance is prevalent.

Effect of double dose of aqueous procaine penicillin to treat gonorrhea in men.

A double dose of aqueous procaine penicillin (APP) effectively treats gonorrhea in men, with a higher cure rate and better treatment outcomes compared to a single intramuscular injection of 2.4 million units.

Spectinomycin hydrochloride (Trobicin) in the treatment of gonorrhoea. Observation of resistant strains of Neisseria gonorrhoeae.

Spectinomycin hydrochloride (Trobicin) is an effective and safe alternative for treating gonorrhoea in patients allergic to penicillin, with resistance to streptomycin and tetracyclines being common.

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