In the past, a penicillin shot was all that was needed to cure gonorrhea. But, high rates of infection coupled with the overuse of penicillin led to widespread antibiotic resistance. Oral antibiotics once used on their own to treat gonorrhea were also met with high levels of resistance, in part because many people failed to complete the course of treatment.
Today, the goal of gonorrhea treatment is to hit the infection hard and fast—ideally with a single dose—so that the bacteria are completely eradicated and don’t have the chance to mutate and become resistant.
This article outlines the current guidelines for the treatment of gonorrhea, including the treatment of sexual partners. It also explains how uncomplicated gonorrhea, disseminated (widespread) gonorrhea, and gonorrhea in newborns are each treated.
Prescriptions
There are six antibiotic drugs recommended for the treatment of gonorrhea by the Centers for Disease Control and Prevention (CDC):
Ceftriaxone (preferred): Delivered either by intramuscular injection (into a large muscle) or intravenously (into a vein) Cefixime (alternative): Delivered by intramuscular injection Gentamicin (alternative): Delivered by intramuscular injection Cefotaxime (alternative): Delivered by intramuscular injection Azithromycin (alternative): Taken by mouth as an oral tablet Erythromycin (for newborns): Applied to the eye as an ointment
Ceftriaxone is the antibiotic most capable of treating gonorrhea on its own. Others may be used either on their own or along with a single oral dose of azithromycin.
Uncomplicated Gonorrhea
Uncomplicated gonorrhea—meaning gonorrhea that is localized to the site of the initial infection—is usually easily treated with a single dose of ceftriaxone. This includes gonorrhea infections of the genitals, throat, and rectum. Gonococcal conjunctivitis, an infection caused by touching your eyes with contaminated fingers, is also treated with a single dose of ceftriaxone.
Other antibiotics, used either alone or in combination, may be prescribed if you are allergic to ceftriaxone or the drug is unavailable.
The dosages are described in milligrams (mg) or grams (g).
In rare cases, meningitis (inflammation of the membrane surrounding the brain and spinal cord) and endocarditis (inflammation of the heart valves) can develop if gonorrhea is left untreated.
If diagnosed with DGI, you will need to be hospitalized for treatment. The duration of treatment depends on the type of complication you have.
Sex partners also need to be contacted, tested, and provided treatment. In certain cases, a partner may be treated without undergoing testing. This is a precautionary measure that not only protects their health but may also prevent the spread of infection.
After treatment is completed, you do not need to undergo further testing to see if the infection has cleared. The only exception is gonorrhea of the throat, which is far more difficult to treat.
Treatment of Newborns
If you are diagnosed with gonorrhea during pregnancy, it is important to seek treatment as soon as possible to prevent passing the infection to your unborn baby. The treatment is the same whether you are pregnant or not and poses no harm to the baby.
Once your baby is born, an ointment containing 5% erythromycin will be applied to the baby’s eyes whether you have been treated or not. This prevents ophthalmia neonatorum, an infection that can occur if gonorrhea gets into the baby’s eyes as it passes through the birth canal.
If you have not been treated (or were diagnosed late in the pregnancy), your baby will be given antibiotics as a precautionary measure. If there are symptoms, more aggressive measures will be taken. In such cases, the dose is prescribed based on the weight of the baby in kilograms (kg).
People with complications of gonorrhea, including newborns, may require intravenous ceftriaxone (or a related antibiotic called cefotaxime) delivered in a hospital.
A Word From Verywell
It is important to note that not everyone with gonorrhea has symptoms. This is especially true of females and people who engage in anal sex.
It is for this reason that the CDC recommends annual gonorrhea and chlamydia testing for all sexually active females under 25. Those 25 and older with risk factors such as new or multiple sex partners or a sex partner with an STI should also be tested annually.
The CDC also recommends annual gonorrhea, chlamydia, syphilis, and HIV testing for sexually active men who have sex with men (MSM). Those with multiple or anonymous sex partners should be tested every three to six months.
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