Daily Bolus of LR: Localized Gonococcal Infection

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July 7, 2011 by dailybolusoflr

Localized Gonococcal Infections


·         N. gonorrhea is the 2nd most common cause of STD infections in the US

·         Men often present quickly due to symptomatic urethral infections, whereas women often are asymptomatic and present late with PID or other complications (tubal scarring, abscess etc)

·         Locations of infection include: male and female GU tract, rectum, pharynx and conjunctiva

·         Not all tests (gram stain and culture, nucleic acid hybridization and nucleic acid amplification) are acceptable for all locations and you should know the limitations of the test you are using

·         Treatment: (these are new, so read!)

o   Uncomplicated cervix/urethra/rectum:

§  ceftriaxone 250mg IM x 1 dose(125mg IM is no longer recommended due to decreased susceptibility and treatment failures as well as improved efficacy of the higher dose for pharyngeal infections which are often missed)  OR

§  cefixime 400mg orally   OR

§  PCN allergic  azithromycin 2g orally (not recommended if patient can tolerate above medications due to rapidity with which resistance can develop)

§  Remember to always empirically treat for Chlamydia as well with doxycycline 100mg bid for 7days or azithromycin 1g orally

§  Pharyngeal infections are treated with ceftriaxone 250mg IM and oral medication for Chlamydia

§  Ocular infection is treated with ceftriaxone 1g IM x 1 dose


Ref: cdc.gov



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