Gonorrhoea Treatment in Singapore: Gonorrhoea treatment clinic, Singapore. Private and confidential service. Definitions, references, and latest news.
Gonorrhoea Treatment is usually with
Uncomplicated infection in adults – urethral, endocervical and rectal infection
Alternative Regimens (for those with allergy)
(Aztreonam has been used in some patients at DSC when other alternatives were unavailable)
It is important to emphasize that treatment of GC should be accompanied with anti-chlamydia therapy. This not only treats concurrent infection, but there is evidence to suggest that concurrent administration of azithromycin would slow down the possibility of the development of cephalosporin resistant strains of GC.
Note: The fluroquinolones (e.g. ciprofloxacin, ofloxacin, norfloxacin) are contraindicated as > 70% of isolates in Singapore and the region are resistant.
Gonococcal infection in pregnancy
Disseminated gonococcal infection or DGI
Hospitalisation under specialist care is recommended.
Therapy should continue for 24-48 hours after improvement begins, and can be converted to an oral cephalosporin therapy for a total of 7 days. Anti-chlamydia therapy should be given at the same time.
Gonococcal acute epididymitis and epididymo-orchitis
Ceftriaxone 500 mg i/m daily x 1 to 3 days with doxycycline 100mg bid x 2 weeks [III, B].
Adult gonococcal ophthalmia
Ceftriaxone 1g i/m single dose with with azithromycin 1g stat or doxycycline 100 bid x 1 week. With lavage of the infected eye with normal saline [IV, C].
Topical antibiotics alone do not eradicate the infection and rigid adherence to topical therapy is not essential. All patients should be referred for ophthalmologic assessment.
Neonatal gonococcal ophthalmia
Topical antibiotics alone do not eradicate the infection. All patients should be referred for ophthalmologic assessment.
Screen the mother and her sexual partners for gonorrhoea and other STIs. The mother should be treated on epidemiological grounds.
Uncomplicated gonococcal infections in older children – urethral, vulvovaginal, cervical, pharyngeal, rectal infections.
Children who weigh > 45 kg or are above 12 years of age should be treated with adult regimens.
Children who weigh < 45 kg or are 12 years of age or younger should be treated as follows:
week (if older than 12 years).
Drugs Not Recommended
The following drugs are not recommended for treating gonococcal infection in Singapore as they are either ineffective or have not been adequately evaluated: