Uncomplicated Gonococcal Infection Clinical Practice Guidelines (CDC, 2020)

Centers for Disease Control and Prevention (CDC)

This is a quick summary of the guidelines without analysis or commentary. For more information, go directly to the guidelines by clicking the link in the reference.

January 29, 2021

The guideline update on the management of uncomplicated urogenital, rectal, or pharyngeal gonorrhea was published in December 2020 by the Centers for Disease Control and Prevention (CDC).[1]

Uncomplicated Gonococcal Infections of Cervix, Urethra, or Rectum

Persons weighing < 150 kg (300 lb) – Administer ceftriaxone 500 mg IM as a single dose.

Persons weighing ≥150 kg (300 lb) – Administer ceftriaxone 1 g IM.

If chlamydial infection has not been excluded, treat for chlamydia with doxycycline 100 mg PO twice daily for 7 days; during pregnancy, treat for chlamydia with azithromycin 1 g as a single dose.

Alternative regimens if ceftriaxone is not available

Administer gentamicin 240 mg IM as a single dose plus azithromycin 2 g orally as a single dose.

Administer cefixime 800 mg orally as a single dose. If treating with cefixime and chlamydial infection has not been excluded, treat for chlamydia with doxycycline 100 mg PO twice daily for 7 days; during pregnancy, treat for chlamydia with azithromycin 1 g as a single dose.

Uncomplicated Gonococcal Infections of Pharynx

Persons weighing < 150 kg (300 lb) – Administer ceftriaxone 500 mg IM as a single dose.

Persons weighing ≥150 kg (300 lb) – Administer ceftriaxone 1 g IM.

If chlamydia coinfection is identified when pharyngeal gonorrhea testing is performed, treat for chlamydia with doxycycline 100 mg PO twice daily for 7 days; during pregnancy, treat for chlamydia with azithromycin 1 g as a single dose.

Alternative regimens if ceftriaxone is not available

No reliable alternative treatments are available for pharyngeal gonorrhea.

Persons with a history of a beta-lactam allergy – Thorough assessment of the reaction is recommended.

Persons with an anaphylactic or other severe reaction (eg, Stevens-Johnson syndrome) to ceftriaxone – Consult an infectious disease specialist for an alternative treatment recommendation.

For more information, please go to Gonorrhea and Chlamydia (Chlamydial Genitourinary Infections).

For more Clinical Practice Guidelines, please go to Guidelines.

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