Antibiotic regimens for treatment of Chlamydia trachomatis and Neisseria gonorrhoeae infections among adolescents and adults

• Preferred regimen for nonpregnant individuals.
• Patients should be counseled on treatment adherence.
• Individuals of child-bearing potential should have pregnancy testing prior to taking.
• Generally avoided during pregnancy.

• Alternative regimen for nonpregnant individuals who cannot take doxycycline or may not be able to complete the full course.
• Preferred regimen for pregnant individuals.

• Reserved for nonpregnant individuals when other fluoroquinolone-susceptible pathogens need to be covered (eg, urethritis with possible gram-negative bacterial co-infection).
• Generally avoided during pregnancy.

Weight <150 kg: 500 mg intramuscularly as a single dose

• Preferred regimen for all individuals.
• Most patients with a penicillin allergy can still use ceftriaxone safely. Depending on the type of allergy, options include:
  • Giving with or without skin testing
  • Giving with a test dose

• Ceftizoxime 500 mg intramuscularly as a single dose
• Cefoxitin 2 g intramuscularly with probenecid 1 g orally as a single dose
• Cefotaxime 500 mg intramuscularly as a single dose

Oral cephalosporin:

• Cefixime 800 mg orally as a single dose

• Alternative regimens if ceftriaxone administration is not available or feasible.
• Efficacy in pharyngeal infection is uncertain (cefixime is associated with treatment failure).
• Certain agents are of limited availability.

• Gentamicin 240 mg if >45 kg (or 5 mg/kg if ≤45 kg) intramuscularly once OR
• Gemifloxacin 320 mg orally once

• Alternative regimens, reserved for patients with urogenital or anorectal gonococcal infection who have severe allergies that preclude cephalosporin use.
• Avoid in pharyngeal infection.
• Gemifloxacin and spectinomycin are of limited availability.