From the Guidelines
The recommended dose of doxycycline for treating gonorrhea is 100 mg taken orally twice daily for 7 days, particularly if chlamydia coinfection is suspected or cannot be ruled out 1. However, doxycycline is not typically used as a first-line treatment for gonorrhea on its own. The current recommended regimen for uncomplicated gonorrhea is a single intramuscular injection of ceftriaxone, plus doxycycline 100 mg orally twice daily for 7 days. This dual therapy approach is important because gonorrhea has developed resistance to many antibiotics over time, and combination therapy helps ensure complete eradication of the infection.
Some key points to consider when taking doxycycline for gonorrhea include:
- Taking the medication with a full glass of water and remaining upright for at least 30 minutes afterward to prevent esophageal irritation
- Taking the medication with food to reduce stomach upset
- Avoiding dairy products, antacids, or supplements containing calcium, aluminum, magnesium, or iron within 2 hours of taking doxycycline as these can reduce its effectiveness
- Completing the full course of antibiotics even if symptoms improve before finishing the treatment
It's also essential to note that sexual partners should be treated to prevent reinfection, and patients should abstain from sexual activity until both they and their partners have completed treatment and are confirmed cured, as indicated in the guidelines 1.
From the FDA Drug Label
Uncomplicated gonococcal infections in adults (except anorectal infections in men) 100 mg, by mouth, twice a day for 7 days. As an alternate single visit dose, administer 300 mg stat followed in one hour by a second 300 mg dose. The recommended dose of doxycycline for treating gonorrhea is:
- 100 mg, by mouth, twice a day for 7 days
- Or, as an alternate single visit dose: 300 mg stat followed in one hour by a second 300 mg dose 2
From the Research
Recommended Dose of Doxycycline for Treating Gonorrhea
- The recommended dose of doxycycline for treating gonorrhea is 100 mg orally twice a day for 7 days 3, 4.
- This dose is recommended as part of a dual therapy regimen, in conjunction with a single 500 mg IM dose of ceftriaxone, for the treatment of uncomplicated urogenital, anorectal, and pharyngeal gonorrhea 3.
- The use of doxycycline in this regimen is intended to treat possible coinfection with Chlamydia trachomatis 3, 4.
Comparison with Other Treatment Regimens
- Studies have compared the efficacy of doxycycline with other antibiotics, such as azithromycin, in the treatment of gonorrhea 5, 6, 7.
- While azithromycin may be preferable as the second agent to treat gonorrhea, doxycycline appears to be a reasonable alternative 6.
- A single dose of azithromycin has been shown to be effective in treating gonorrhea, but doxycycline is typically administered for 7 days 7.
Important Considerations
- The treatment of gonorrhea requires careful consideration of antimicrobial resistance and the potential for treatment failures 3, 5, 4.
- Health care providers should monitor for the emergence of ceftriaxone resistance and report treatment failures to ensure the continued efficacy of recommended regimens 3.