Treatment guidelines for sexual health checks and treatment of gonorrhoea (NG) are in a state of flux internationally.
The updated NZ guidelines1 suggest an NG culture and susceptibilities in primary care for:
- females (endocervical swab) if suspected PID or profuse cervical discharge or a contact of an NG case
- male (urethral swab) if frank discharge in the meatus
- transgender/non-binary people as per genital organs present.
For patients with NG and chlamydia (CT), 1 gm ceftriaxone for the NG and doxycycline 100mg BD with food for 7 days for the CT.
An early test of cure is now only recommended for NG in pregnancy or pharyngeal infections and pregnancy or rectal infections for CT.
Currently, for NG only cases, give 500mg of ceftriaxone IM and 1 gm stat of azithromycin.
For uncomplicated CT infection in genital or pharyngeal region, doxycycline BD for 7 days is first option.
This Gem has been checked by Dr Massimo Giola, Infectious Disease and Sexual Health Physician BOP and Lakes DHBs.