Podcast 626: Updated Gonorrhea Treatment - The Emergency Medical Minute

Podcast 626: Updated Gonorrhea Treatment

Educational Pearls:

  • The CDC has made new formal recommendations for treating Gonorrhea due to increasing resistance to Rocephin and Azithromycin.
  • New recommendations:
    • Confirmed gonorrhea: Ceftriaxone 500 mg once
    • Empiric treatment: Ceftriaxone 500 mg once followed by 7 days Doxycycline 100 mg BID
    • No longer using Azithromycin due to high resistance
  • Second line:
    • Gentamycin IM
    • Cefixime 800 mg oral
  • Pharyngeal involvement has high resistance rates to second line agents and ceftriaxone is strongly preferred


St. Cyr S, Barbee L, Workowski KA, et al. Update to CDC’s Treatment Guidelines for Gonococcal Infection, 2020. MMWR Morb Mortal Wkly Rep 2020;69:1911–1916. DOI: http://dx.doi.org/10.15585/mmwr.mm6950a6.

Summarized by Jackson Roos, MS4 | Edited by Erik Verzemnieks, MD

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