Gonorrhea, a sexually transmitted disease, can only be treated with antibiotics. Once your diagnosis of gonorrhea is confirmed, complete treatment for cure is essential in view of its dangerous complications, if left untreated.

There are no home remedies to treat gonorrhea. You must seek professional medical advice to treat it with antibiotics. That is the only way to cure this sexually transmitted infection (STI) and avoid long-term complications.

Gonorrhea is essentially treated with antibiotics. They are very effective against the causative organism, Neisseria gonorrhoeae bacterium. The line of treatment remains the same in males and females.

This post explains the full treatment of gonorrhea and its complications along with the treatment of gonorrhea during pregnancy and of the newborn of an infected mother.

Gonorrhea treatment

In adult men and women

Formerly gonorrhea used to be effectively treated with penicillin, tetracyclines, and fluoroquinolones.

Today, these antibiotics do not work due to the resistance developed by the gonorrhea bacteria to them. Newer-generation antibiotics have to be used.

Earlier, after the 1940s, penicillin was effective in treating gonorrhea and was the drug of choice for several decades.

After 1976, the gonorrhea bacteria acquired resistance to this drug, and penicillin efficacy no longer existed.

In view of the above, The Centers for Disease Control and Prevention (CDC) recommends an injectible antibiotic, ceftriaxone along with oral azithromycin or doxycycline for an uncomplicated case of gonorrhea.

If you’re allergic to cephalosporin antibiotics, such as ceftriaxone, you might be given an alternative, oral gemifloxacin (Factive) or injectable gentamicin and oral azithromycin.

The best line of treatment for gonorrhea is a single-dose antibiotic. Ceftriaxone 500 mg intramuscular injection single dose is given along with azithromycin 1 g orally. Both are given in one sitting.

Or, Ceftriaxone 500 mg intramuscular injection single dose is given along with Doxycycline 100 mg orally twice a day for 7 days. In such cases, do not have sex at least for seven days after treatment.

This prescribed high dose of Ceftriaxone is necessary in view of resistance to lower dose strength and efficacy in oral gonococcal infection.

The above-mentioned combination of antibiotics works very well against the gonorrhea bacteria and permanently cures the gonococcal infection.

It is safe for use in pregnancy and has the added advantage of controlling the incubation of syphilis.

The fully advised dose should be taken for the prescribed time. However, resistant cases to ceftriaxone are also reported, but rarely.

It takes 7 days for the antibiotics to completely cure gonorrhea in your body. If you have sex without a condom during these 7 days after taking the medicine, you could still pass the infection to your sex partners, even if you have no symptoms.

It, therefore, becomes necessary to test the patient one week after the completion of gonorrhea treatment to confirm a complete cure.

Your partner/s should be identified and screened. A positive partner should also be treated with the same treatment you have received.

And, both of you should confirm a complete cure post-treatment through testing. This is to avoid re-infection and the spread of the disease.

Sex can be resorted to after a complete cure is confirmed and with a go-ahead from your doctor.

Treatment of gonorrhea in pregnancy

Gonorrhea should be immediately treated in a pregnant woman as soon as it is detected irrespective of the trimester.

Antibiotics used to treat gonorrhea are relatively safe with very few side effects. Treating gonorrhea in pregnancy is necessary in view of the complications it can have in the newborn.

Ceftriaxone and spectinomycin are safe and most effective for treating gonorrhea in pregnancy.

Amoxicillin with probenecid combination has a lower efficacy and is not recommended for the treatment of gonorrhea in pregnancy.

Treatment of newborn

Babies born to mothers with gonorrhea infection should be immediately treated with eye drops prophylactically immediately after birth.

This is because the eye infection of a baby born to an infected mother is the most common complication in the newborn. However, if other gonorrhea symptoms appear, antibiotics will have to be administered.

Gonorrhea treatment failure

If the symptoms still persist even after treatment, it means that the gonorrhea bacteria are resistant to the antibiotics administered to you.

Culture of the fluid collected from the urethra or the endocervix or the anal canal or the throat is done. It tells you the antibiotics to which the bacteria are sensitive and the treatment can then be changed accordingly.

Treatment of gonorrhea complications

How are the four most common complications of gonorrhea treated?

1. Gonococcal arthritis

Ceftriaxone at 1 g daily IV/IM initially should be continued for up to two days after the symptoms improve followed by cefixime 400 mg orally twice daily for 7 days.

2. Pelvic inflammatory disease (PID) 

Cefoxitin at 2 g IM along with probenecid at 1g orally as a single dose or Ceftriaxone at 250 mg IM followed by a 14-day oral regimen of doxycycline 100 mg twice daily.
The above regimens may be accompanied by metronidazole 500 mg orally twice daily for 14 days.

3. Gonococcal epididymitis

Ceftriaxone 250 mg IM as a single dose with doxycycline 100 mg orally twice daily for 10 days is recommended.

4. Disseminated gonococcal infection

Patients with disseminated gonococcal infection may require hospitalization depending on their condition and the complications that have occurred. Briefly, treatment may be as follows:

  • Ceftriaxone 1 g IM/IV every 24 hours, or
  • Cefotaxime 1 g IV every 8 hours, or
  • Ceftizoxime 1 g IV every 8 hours

What are the common side effects of gonorrhea medication?

Some may experience minor side effects with medications given for treating gonorrhea. They include:

  • Headache
  • Nausea
  • Vomiting
  • Stomach pain
  • Indigestion
  • Bloating

How to prevent catching gonorrhea?

Preventing gonorrhea, a sexually transmitted disease, should become a necessary lifetime observation in view of its serious complications and the stats that show how widespread it is and how easy it is to catch this infection. These preventive measures are simple and easy to follow.

They become more important for three reasons:

  1. 40% of the gonorrhea patients also have Chlamydia infection (another STD infection)
  2. 10% of the infected males and 80% of the infected females are asymptomatic (without symptoms). If symptoms do appear, they do so after a window period (incubation period) of 2 to 10 days after the person has gotten infected. But at times, they can occur even after a month. This infected person can infect another even though he or she has no symptoms and even during the incubation period.
  3. The gonorrhea bacteria are resistant to antibiotics that were formerly very effective in their treatment Newer antibiotics have to be used in their treatment to which resistance is sometimes seen.

Preventive tips

  • Always use a properly fitting condom correctly and consistently. Though not a 100% risk-free step, it will significantly reduce your STD risk.
  • If you have a new partner, you must get him or her screened for all sexually transmitted diseases.
  • If you are leading a high STD-risk life, get yourself screened, treated if necessary, and stick to one partner who does not have gonorrhea or any STD for that matter. Multiple partners are a very high-risk lifestyle to have. This type of lifestyle requires regular screening for STDs.
  • Do not have sex with any partner who has STD symptoms even with a condom. According to a report released by the U.S. National Institutes of Health in July 2001, there is no scientific evidence that condoms prevent the transmission of most sexually transmitted diseases (STDs). When used correctly and consistently, condoms were found to reduce the risk of heterosexual gonorrhea infection by 85 percent. The important point here is that gonorrhea is less frequently transmitted from female to male.
  • Use condoms on sexual devices like dildos too. Clean and disinfect these sexual devices after and before use.
  • Always use water-soluble lubricants on condoms to prevent tear.
  • Avoid drinking alcohol beyond your safe level. Avoid drugs too. These intoxicants tend to make you reckless and go in for unprotected sex.
  • Use dental dams when indulging in oral sex.
  • The surest shot way to prevent getting or giving gonorrhea is to be monogamous. Stick to one partner who has been screened and is known to be not infected. Also, make sure the partner is also sticking only to you.
  • Abstaining from sex is another great preventive step but may not be practical.