- Ceftriaxone 500 mg IM stat
Followed by treatment for Chlamydia trachomatis particularly if testing for chlamydia is not available or a patient is unlikely to return for treatment if the chlamydia result is positive
- Azithromycin 1 g taken as a single oral dose
or
- Doxycycline 100 mg bd (or 200mg once-daily) for 7 days
Ciprofloxacin resistance is now common in Victoria, and should not be used for treatment of gonorrhea.
REVIEW
All patients with gonorrhoea should be tested for HIV and syphilis at least six weeks after infection.A repeat test to exclude re-infection is recommended at three months as re-infection rates are high. Test-of-cure for is not recommended. However, repeat testing should be performed at least 3 weeks after completion of treatment if symptoms persist or if there is concern regarding adherence or reinfection from an inadequately treated partner.
PARTNER NOTIFICATION
Partner notification should be discussed with patients. Consider referring patients to the Let Them Know website (www.letthemknow.org.au) which is designed to support patients to undertake partner notification and which facilitates sending of SMS and email messages to partners. Partners should be contacted, tested and treated without waiting for their test results. Individuals should abstain from sex with their partners until 7 days after both have received treatment.