Table 1:

Testing and treatment for uncomplicated gonococcal infection^1,3

Specimen site	Test	Preferred treatment*†
Urine	NAAT	Ceftriaxone¶ 250 mg intramuscularly once or cefixime 800 mg orally once plus azithromycin 1 g orally once
Male urethra	Gram stain, culture or NAAT‡
Female urethra or endocervix	Gram stain, culture or NAAT‡
Rectum	Culture or NAAT§
Pharynx	Culture or NAAT§	Ceftriaxone 250 mg intramuscularly once plus azithromycin 1 g orally once

Note: NAAT = nucleic acid amplification test.

^*Alternative treatments include azithromycin 2 g orally once, spectinomycin 2 g intramuscularly once, ciprofloxacin 500 mg orally once and ofloxacin 400 mg orally once. Fluoroquinolones should be used only for culture-proven susceptible infections, or if local resistance is less than 5% and a test of cure can be performed.¹

^†In all symptomatic men who have sex with men, culture should be performed before treatment to obtain drug susceptibilities.³

^‡In asymptomatic individuals, NAAT is the preferred screening test (urine for men and endocervical swab for women). For women, urine may be used if endocervical swab is unavailable.¹

^§NAAT may be performed for rectal and pharyngeal cultures in microbiology laboratories that have validated tests for these body sites.¹

^¶In men who have sex with men, ceftriaxone 250 mg intramuscularly plus azithromycin 1 g orally is recommended for all forms of gonorrhea.³