What are the cause, risk factors, preventive measures, signs and symptoms, and treatment of Neisseria gonorrhoeae (Gonorrhea) infection?

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Last updated: February 19, 2025 • View editorial policy

From the Guidelines

Gonorrhea is a sexually transmitted infection (STI) caused by the bacterium Neisseria gonorrhoeae. To minimize the risk of infection, it is recommended to practice safe sex by using condoms consistently and correctly.

Cause and Risk Factors

The cause of gonorrhea is the transmission of Neisseria gonorrhoeae through vaginal, anal, or oral sex with an infected person [ 1 ]. Risk factors include having multiple sex partners, a history of STIs, and unprotected sex.

Preventive Measures

Preventive measures include using condoms, getting tested regularly for STIs, and avoiding sex with someone who has an STI [ 2 ]. Vaccination against human papillomavirus (HPV) can also help reduce the risk of gonorrhea.

Signs and Symptoms

Signs and symptoms of gonorrhea may include:

  • Painful urination
  • Increased vaginal discharge
  • Abdominal pain
  • Bleeding between periods in women
  • Painful urination
  • Discharge from the penis
  • Swollen testicles in men

Treatment

Treatment for gonorrhea typically involves a single dose of the antibiotic ceftriaxone (250mg intramuscularly) plus a single dose of azithromycin (1g orally) [ 1 ]. Alternative treatments may include ceftriaxone (250mg intramuscularly) plus doxycycline (100mg orally twice daily for 7 days). It is essential to complete the full treatment course and follow up with a healthcare provider to ensure the infection has been fully cleared. Additionally, all sex partners from the past 60 days should be notified and treated [ 2, 3 ].

From the FDA Drug Label

Uncomplicated Gonorrhea (cervical/urethral and rectal) caused by Neisseria gonorrhoeae, including both penicillinase- and nonpenicillinase-producing strains, and pharyngeal gonorrhea caused by nonpenicillinase-producing strains of Neisseria gonorrhoeae. Cefixime for oral suspension and cefixime capsule is indicated in the treatment of adults and pediatric patients six months of age or older with uncomplicated gonorrhea (cervical/urethral) caused by susceptible isolates of Neisseria gonorrhoeae (penicillinase- and non-penicillinase-producing isolates).

The cause of Neisseria gonorrhoeae (Gonorrhea) infection is the bacterium Neisseria gonorrhoeae. The risk factors are not explicitly stated in the drug label. Preventive measures are not explicitly stated in the drug label. The signs and symptoms are not explicitly stated in the drug label. The treatment of uncomplicated gonorrhea is ceftriaxone (IM) or cefixime (PO), with a recommended dose of:

  • ceftriaxone: 1 g as a single dose
  • cefixime: 400 mg as a single oral dose 4 5

From the Research

Cause and Risk Factors of Neisseria gonorrhoeae Infection

  • Neisseria gonorrhoeae is a bacterium that causes the sexually transmitted infection (STI) gonorrhea 6
  • The main risk factors for acquiring the infection include multiple sexual partners, unsafe sex, and substance use habits 7
  • Other risk factors include less frequent condom use and alcohol intake 7
  • The rate of infection is higher in males than in females, and also higher in the 20-24 years age group 7

Preventive Measures

  • Prevention relies on promoting safe sexual behaviors and reducing STI-associated stigma 6
  • The use of condoms can help reduce the risk of transmission 7
  • Behavioral risk reduction is essential in preventing the spread of the infection 7

Signs and Symptoms

  • Gonorrhea can present as urethritis in men, cervicitis or urethritis in women, and in extragenital sites (pharynx, rectum, conjunctiva and, rarely, systemically) in both sexes 6
  • The proportion of urogenital symptoms attributable to N. gonorrhoeae is high, with the highest prevalence among males and young adults 7

Treatment

  • Single-dose systemic therapy (usually injectable ceftriaxone plus oral azithromycin) is the recommended first-line treatment 6
  • Broad-spectrum cephalosporin-based combination therapies are currently recommended for treatment of uncomplicated urogenital and anorectal gonococcal infections 8
  • Ceftriaxone and cefoxitin can be considered as excellent first-line treatment options 7
  • However, the emergence of antibiotic-resistant strains, including resistance to ceftriaxone, is a major public health concern 9, 10, 6, 8
  • Alternative strategies like immunotherapy and phage therapy are being explored, and there is a need to optimize drug therapy and develop new antibiotics 10

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.