GC/CT Treatment (CDC 2021): Azithromycin is no longer first-line for Gonorrhoea. Ceftriaxone monotherapy is preferred when CT is excluded.
Target Pathogen
Gonorrhoea Treatment
Ceftriaxone 500mg IM x1
Dual therapy only if CT not ruled out
Guidelines & Evidence
Clinical Details
Section 1
Gonorrhoea
Uncomplicated (Urogenital/Rectal/Pharyngeal)
["First-line: Ceftriaxone 500 mg IM x 1 (for weight <150kg).","Note: If weight ≥150kg, use Ceftriaxone 1 g IM x 1.","Chlamydia Not Ruled Out: Add Doxycycline 100 mg PO BID x 7 days."]
Penicillin/Cephalosporin Allergy
Gentamicin 240 mg IM x 1 PLUS Azithromycin 2 g PO x 1.
Section 2
Chlamydia
First-line therapy
Doxycycline 100 mg PO BID for 7 days.
Alternative (e.g. Pregnancy)
Azithromycin 1 g PO x 1. Note: Azithromycin is no longer first-line for non-pregnant adults due to efficacy concerns.
Section 3
Partner / Follow-up
EPT (Expedited Partner Therapy)
Legal in most US states. Provide prescription or meds for partners without clinical evaluation.
Test of Cure (TOC)
Not routine for urogenital GC/CT. Recommended for pharyngeal GC or if alternative regimens used.
