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Gonorrhoea Treatment Singapore | STD

Gonorrhoea Treatment in Singapore: Gonorrhoea treatment clinic, Singapore. Private and confidential service. Definitions, references, and latest news.

Gonorrhoea Treatment is usually with

 

 

 

TREATMENT

Recommended regimens

Uncomplicated infection in adults – urethral, endocervical and rectal infection

  1. Ceftriaxone 500 mg i/m single dose + azithromycin 1-2g stat or doxycycline 100 bid x 1-2 weeks [IV, C]

Alternative Regimens (for those with allergy)

  1. Cefotaxime 1g i/m single dose + azithromycin 1-2g stat or doxycycline 100 bid x 1-2 weeks [1b]
    or
  2. Spectinomycin 2g i/m single dose + azithromycin 1-2g stat or doxycycline 100 bid x 1-2 weeks [1b, A]
    or
  3. Azithromycin 2g stat [II, C] (not as monotherapy)
    or
  4. Aztreonam 1g i/m single-dose dose with azithromycin 1-2g stat or doxycycline 100 bid x 1-2 weeks [1b]

(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

Pharyngeal infection

  1. Ceftriaxone 500 mg i/m single dose with azithromycin 1g stat or doxycycline 100 bid x 1 week [IV, C].

Disseminated gonococcal infection or DGI

Hospitalisation under specialist care is recommended.

  1. Ceftriaxone 1g i/m or i/v daily
    or
  2. Cefotaxime 1g i/v 8 hourly
    or
  3. Spectinomycin 2 g i/m 12 hourly

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

  1. Ceftriaxone 25-50 mg/kg i/m single dose not to exceed 125 mg
    or
  2. Cefotaxime 100 mg/kg i/m single dose. With lavage of the infected eye with normal saline.

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:

  1. Ceftriaxone 125 mg i/m single dose with azithromycin 1g stat or doxycycline 100 bid x 1 week (if older than 12 years).
    or
  2. Cefotaxime 125 mg i/m single dose with azithromycin 1g stat or doxycycline 100 bid x 1

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:

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