• Referral to Sexual health should be made for treatment, partner notification and follow up.
  • Diagnosis is usually by PCR/NAAT of urine or swab (vaginal, throat, rectal)
  • Prior to treatment a charcoal swab from the site of infection should be taken to establish antimicrobial sensitivities (no need to await the result prior to treatment).
  • Partners will require testing +/- treatment
  • Test of cure should be performed 2 weeks after treatment (no sooner) as resistance strains are increasing.

Drug details

Gonorrhoea (uncomplicated ano-genital and pharyngeal infection)

Preferred option for patients who are pregnant or breastfeeding

Ceftriaxone (intramuscular) 1 gram


As a single dose

Alternatives suitable for allergy, needle phobia or other absolute or relative contraindications.
Give dual therapy to avoid treatment failure, especially in pharyngeal infections.

Cefixime 400mg
Azithromycin 2 gram

As a single dose

In proven beta-lactam allergy.
If known severe renal impairment (eGFR below 30) contact Sexual Health or Microbiology.

Gentamicin (intramuscular) 240mg
Azithromycin 2 gram

As a single dose

Last reviewed: 27 April 2022

Next review: 27 April 2025

Author(s): Antimicrobial Management Team

Approved By: TAM Subgroup of ADTC

Reviewer Name(s): Area Antimicrobial Pharmacist

Document Id: AMT125