Skip to main content

Unfortunately we don't fully support your browser. If you have the option to, please upgrade to a newer version or use Mozilla Firefox, Microsoft Edge, Google Chrome, or Safari 14 or newer. If you are unable to, and need support, please send us your feedback.

We'd appreciate your feedback.Tell us what you think! opens in new tab/window

Elsevier
Publish with us
AI-Generated response:

Patients who are diagnosed with Gonorrhea are also treated for which another coinfection?

Answer generated on June 4, 2024

The AI-generated responses are for illustration purposes only and should not be used for medical purposes.

Patients diagnosed with gonorrhea are also treated for Chlamydia trachomatis coinfection.

  • Chlamydia trachomatis is the most common sexually transmitted coinfection with gonorrhea, and if chlamydial infection has not been excluded, doxycycline for 7 days is recommended.[1]

  • All patients presumed or proven to have gonorrhea should be evaluated for concurrent Chlamydia trachomatis infection, with a high incidence of co-infection noted among males (15–25%) and females (35–50%).[2]

  • Patients should be treated presumptively for C. trachomatis infection unless a negative chlamydial NAAT result is documented at the time treatment is initiated for gonorrhea.[2]

  • If chlamydial test results are not available or if a non-NAAT result is negative for Chlamydia, patients should be treated for both gonorrhea and Chlamydia infection.[2]

  • The recommended treatment for Chlamydia trachomatis when co-infected with gonorrhea includes doxycycline (100mg orally twice daily for 7 days) or a single dose of 1g oral azithromycin as a substitute if adherence to doxycycline is a concern.[3]

Additional info

When treating patients for gonorrhea, it is crucial to consider the high likelihood of co-infection with Chlamydia trachomatis due to their similar transmission routes and risk factors. The Centers for Disease Control and Prevention (CDC) guidelines recommend dual therapy to address both infections effectively, which helps in preventing the potential complications associated with untreated chlamydial infection, such as pelvic inflammatory disease in women and epididymitis in men. This approach also aligns with efforts to curb antimicrobial resistance by ensuring appropriate use of antibiotics. Therefore, simultaneous treatment for both pathogens not only addresses the immediate health needs of the patient but also broader public health goals.

References

Reference 1

1.

Elsevier ClinicalKey Clinical Overview

Treatment Chlamydia trachomatis (urethritis or cervicitis) is the most common sexually transmitted coinfection If chlamydial infection has not been excluded, doxycycline for 7 days is recommended

Reference 2

2.

Hsu, Katherine, Ram, Sanjay, Darville, Toni (2025). Neisseria gonorrhoeae (Gonococcus). In Nelson Textbook of Pediatrics (pp. 1747). DOI: 10.1016/B978-0-323-88305-4.00238-8

All patients who are presumed or proven to have gonorrhea should be evaluated for concurrent syphilis, HIV, andChlamydia trachomatisinfection. The incidence ofChlamydiaco-infection is 15–25% among males and 35–50% among females. Patients beyond the neonatal period should be treated presumptively forC. trachomatisinfection unless a negative chlamydial NAAT result is documented at the time treatment is initiated for gonorrhea. However, if chlamydial test results are not available or if a non-NAAT result is negative forChlamydia,patients should be treated for both gonorrhea andChlamydiainfection (seeChapter 272.2). Persons who receive a diagnosis of gonorrhea should be instructed to abstain from sexual activity for 7 days after treatment and until all sex partners are adequately treated (7 days after receiving treatment and resolution of symptoms, if present). Sexual partners exposed in the preceding 60 days should be examined, specimens collected, and presumptive treatment started. N. gonorrhoeaehas progressively developed resistance to the antibiotics used to treat it. Antimicrobial resistance inN. gonorrhoeaeoccurs as plasmid-mediated resistance to penicillin and tetracycline and chromosomally mediated resistance to penicillins, tetracyclines, spectinomycin, fluoroquinolones, cephalosporins, and azithromycin. Emergence of cephalosporin resistance worldwide has prompted designation ofN. gonorrhoeaeas antibiotic-resistance threat level “Urgent” by the CDC. Surveillance data from the CDC Gonococcal Isolate Surveillance Project reveal concerning fluctuations in minimum inhibitory concentration (MIC) for the oral cephalosporincefiximeand the injectable third-generation cephalosporinceftriaxone, leading the CDC to revise its U.S. gonorrhea treatment guidelines in 2012 to dual therapy (usually a combination of ceftriaxone and azithromycin) in an attempt to preserve the last commercially available effective treatment.

Reference 3

3.

Klausner, Jeffrey D., Taylor, Stephanie N. (2024). In Goldman-Cecil Medicine (pp. 1946). DOI: 10.1016/B978-0-323-93038-3.00275-6

The current U.S. recommendation for the treatment of uncomplicated gonorrhea of the urethra, cervix, rectum, or throat is a single dose of ceftriaxone 500mg by intramuscular injection.10,11If chlamydia is also a possibility, doxycycline (100mg orally twice daily for 7 days) should be added (seeTable 264-5); if adherence is an issue, 1g oral azithromycin given once can substitute for doxycycline. European guidelines recommend ceftriaxone (1g intramuscularly) plus azithromycin (2g orally once).An alternative to ceftriaxone is cefixime (800mg one dose orally).When a molecular gyrase A test is available and predicts ciprofloxacin susceptibility, ciprofloxacin (500mg one dose orally) may be used. If patients are allergic to cephalosporins or have a resistant organism, single-dose gentamicin (240mg intramuscularly) plus azithromycin (2g orally) is recommended.Gentamicin monotherapy is unreliable for pharyngeal gonorrhea, but azithromycin (2g orally) appears to be effective. Patients treated for pharyngeal infection should undergo a test of cure at 7 to 14 days after treatment. Pregnant women treated for gonorrhea should undergo a test of cure by repeat nucleic acid amplification testing at 3 to 4 weeks after treatment. Because of the high incidence of repeated infection, all treated patients should undergo screening at 3 months after treatment to exclude a new infection.

Follow up questions