Antibiotic regimens for asymptomatic anorectal or genital gonococcal infection
To treat asymptomatic anorectal or genital gonococcal infection, as a 2-drug regimen, useOng, 2023:
ceftriaxone 500 mg intramuscularly or intravenously, as a single dose ceftriaxone ceftriaxone ceftriaxone
PLUS
azithromycin 1 g orally, as a single dose. azithromycin azithromycin azithromycin
An amoxicillin-based regimen can be used to treat asymptomatic genital gonococcal infection if susceptibility to penicillin is confirmed. It can also be used in areas where penicillin-resistant N. gonorrhoeae is less common (mainly in some remote areas of northern and central Australia); however, always check with the local public health authority because resistant strains are increasingly found across Australia. As a 3-drug regimen, use:
amoxicillin 3 g orally, as a single dose. For dosage adjustment in adults with kidney impairment, see amoxicillin dosage adjustment amoxicillin amoxicillin amoxicillin
PLUS
probenecid 1 g orally, as a single dose probenecid probenecid probenecid
PLUS
azithromycin 1 g orally, as a single dose. azithromycin azithromycin azithromycin
Do not use the amoxicillin-based regimen for patients who have an anorectal infection; use ceftriaxone plus azithromycin (as above).
For patients who have had a nonsevere (immediate or delayed) hypersensitivity reaction to a penicillin, use ceftriaxone plus azithromycin (as above).
For patients who have had a severe (immediate or delayed)1 hypersensitivity reaction to a penicillin, seek expert advice.