What is the Rocephin (Ceftriaxone) regimen for Sexually Transmitted Diseases (STDs)?

From the Guidelines

For the treatment of gonococcal infections, the recommended regimen is ceftriaxone 1 g intramuscularly or intravenously as a single dose, as stated in the 2024 European Association of Urology guidelines 1. This regimen is often combined with other antibiotics depending on the specific infection. For gonorrhea, ceftriaxone should be paired with azithromycin 1 gram orally as a single dose or doxycycline 100 mg orally twice daily for 7 days to address potential co-infection with chlamydia and to help prevent antibiotic resistance. Some key points to consider:

• The dosage and administration of ceftriaxone may vary depending on the specific infection and patient population.
• Patients should be advised to abstain from sexual activity until treatment is complete and partners have been treated.
• They should also be tested for other STDs including HIV, as co-infections are common.
• Some patients may experience pain at the injection site, allergic reactions, or gastrointestinal symptoms, and those with a penicillin allergy should be monitored closely as there is potential for cross-reactivity. The most recent and highest quality study, the 2024 European Association of Urology guidelines, provides the most up-to-date recommendations for the treatment of gonococcal infections 1. Other studies, such as the 2012 Morbidity and Mortality Weekly Report 1, the 2002 MMWR Recommendations and Reports 1, the 1998 MMWR Recommendations and Reports 1, and the 2006 MMWR Recommendations and Reports 1, also provide guidance on the treatment of gonococcal infections, but the 2024 guidelines are the most recent and should be prioritized.

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. The recommended ROCEPHINE REGIME FOR STD is a single dose of ceftriaxone for injection USP for the treatment of uncomplicated gonorrhea.

• The dose is 1 g.
• It is effective against Neisseria gonorrhoeae, including both penicillinase- and nonpenicillinase-producing strains.
• It can be used to treat cervical/urethral and rectal gonorrhea, as well as pharyngeal gonorrhea caused by nonpenicillinase-producing strains of Neisseria gonorrhoeae 2.

From the Research

ROCEPHINE Regime for STD

• The term "ROCEPHINE" is not explicitly defined in the provided studies, but based on the context, it appears to be related to the treatment of sexually transmitted diseases (STDs), particularly gonorrhea.
• The recommended treatment for gonorrhea, as stated in the studies, is a single 500 mg intramuscular (IM) dose of ceftriaxone 3, 4.
• If chlamydial infection has not been excluded, concurrent treatment with doxycycline (100 mg orally twice a day for 7 days) is recommended 3, 4.
• Alternative treatments, such as cefixime, have been studied and shown to be effective in treating uncomplicated gonorrhea 5.
• The development of antimicrobial resistance is a major concern, and the use of dual therapy, such as ceftriaxone and azithromycin, has been reevaluated due to the increasing incidence of azithromycin resistance 3, 4.
• New antibiotics, such as aminomethyl spectinomycins, are being developed to treat drug-resistant gonorrhea and chlamydial coinfections 6.

Key Findings

• Ceftriaxone is the recommended treatment for uncomplicated gonorrhea 3, 4.
• Azithromycin resistance is increasing, and alternative treatments are being considered 3, 4.
• Dual therapy, such as ceftriaxone and doxycycline, may be recommended to treat gonorrhea and chlamydial coinfections 3, 4.
• New antibiotics, such as aminomethyl spectinomycins, are being developed to treat drug-resistant gonorrhea and chlamydial coinfections 6.

Treatment Options

• Ceftriaxone: a single 500 mg IM dose for the treatment of uncomplicated urogenital, anorectal, and pharyngeal gonorrhea 3, 4.
• Doxycycline: 100 mg orally twice a day for 7 days to treat chlamydial coinfections 3, 4.
• Cefixime: a single oral dose of 400 or 800 mg for the treatment of uncomplicated gonorrhea 5.
• Aminomethyl spectinomycins: a new class of antibiotics being developed to treat drug-resistant gonorrhea and chlamydial coinfections 6.