From the Guidelines
The treatment for Chlamydia and gonorrhea is typically a combination of antibiotics.
Treatment for Chlamydia
- The recommended treatment for Chlamydia includes azithromycin or doxycycline 1.
- Azithromycin can be given as a single-dose, directly observed therapy, and may be the more cost-effective option in many settings.
- Doxycycline is typically given for 7 days.
Treatment for Gonorrhea
- The recommended treatment for gonorrhea is combination therapy with ceftriaxone 250 mg intramuscularly and either azithromycin 1 g orally as a single dose or doxycycline 100 mg orally twice daily for 7 days 1.
- This combination therapy is recommended due to the increasing resistance of Neisseria gonorrhoeae to antimicrobials.
- Cefixime is no longer recommended as a first-line treatment for gonorrhea due to declining susceptibility among urethral N. gonorrhoeae isolates 1.
Important Considerations
- Concomitant therapy with a regimen effective against Chlamydia is recommended due to the frequency of dual infections 1.
- Patients with gonorrhea who have recently traveled to areas with high rates of quinolone-resistant gonorrhea should receive a nonquinolone treatment regimen 1.
From the Research
Treatment for Chlamydia and Gonorrhea
- The recommended treatment for gonorrhea is a single 500 mg intramuscular (IM) dose of ceftriaxone 2.
- For chlamydia, doxycycline is the preferred treatment, with a dosage of 100 mg orally twice a day for 7 days 2, 3.
- Azithromycin is also effective against chlamydia, with a single 1 g dose showing similar effectiveness as a 7-day regimen of doxycycline 4.
- Concurrent treatment with doxycycline is recommended if chlamydial infection has not been excluded in patients with gonorrhea 2.
Considerations for Treatment
- Antimicrobial resistance is a concern for gonorrhea treatment, and ceftriaxone is the recommended treatment due to its low resistance rate 2, 5.
- Patient compliance with treatment is crucial, and single-dose therapy with azithromycin may be justified in cases where compliance is a concern 6.
- The choice of antibiotic should be dictated by the patterns of resistance in the locality of the clinician 6.