From the FDA Drug Label
- 5 Uncomplicated Gonorrhea (cervical/urethral) 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).
- 1 Adults The recommended dose of cefixime is 400 mg daily. This may be given as a 400 mg capsule daily. For the treatment of uncomplicated cervical/urethral gonococcal infections, a single oral dose of 400 mg is recommended.
The recommended treatment for gonorrhoea in Pilbara, Australia is a single oral dose of 400 mg of cefixime.
- Dose: 400 mg
- Administration: single oral dose
- Drug: cefixime 1
From the Research
The recommended treatment for gonorrhoea in the Pilbara region of Australia is a dual therapy approach consisting of ceftriaxone 500mg as a single intramuscular injection plus azithromycin 1g orally as a single dose. This combination therapy is necessary because of increasing antibiotic resistance in Neisseria gonorrhoeae, the bacterium that causes gonorrhoea, as highlighted in a 2019 study 2. Ceftriaxone targets the bacterial cell wall while azithromycin inhibits protein synthesis, providing complementary mechanisms of action to ensure eradication of the infection.
Key considerations for treatment include:
- Patients should abstain from sexual activity for 7 days after treatment and until symptoms have resolved.
- All sexual partners from the previous 2 months should be notified, tested and treated empirically even if asymptomatic.
- A test of cure is recommended 2 weeks after treatment completion, particularly important in the Pilbara where antimicrobial resistance patterns may differ from urban centers, as discussed in a study from 2015 3.
- Pregnant women should receive the same treatment as it is safe during pregnancy.
- If symptoms persist after treatment, patients should return for reassessment as this may indicate antibiotic resistance or reinfection, a concern also raised in a 2019 review 4 and a study on new treatment options 5.
The choice of dual therapy is supported by in vitro synergy testing, which shows that combinations of antimicrobial agents like ceftriaxone and azithromycin are effective against Neisseria gonorrhoeae, including strains with reduced susceptibility to cefixime, as demonstrated in a 2013 study 6. However, the emergence of resistance to these drugs is a concern, and new antimicrobials, such as zoliflodacin, are being developed to address this issue, as noted in a 2019 article on new treatment options 5.