Treatment of asymptomatic Neisseria gonorrhoeae infection

Take a sample for culture and susceptibility testing before starting antibiotic therapy because antimicrobial resistance in strains of Neisseria gonorrhoeae is emerging. Refer to the Australian STI Management Guidelines for Use in Primary Care for current information about antibiotic therapy before prescribing.

Combination therapy with azithromycin and ceftriaxone is recommended for asymptomatic gonococcal infection to delay cephalosporin resistance in N. gonorrhoeae. The dose of azithromycin required for pharyngeal infection is higher than that for anorectal or genital infection because drug penetration into the pharyngeal mucosa is reducedOng, 2023.

Quinolone resistance is widespread in N. gonorrhoeae – do not use ciprofloxacin unless susceptibility is confirmed.