Healthy Living

Treatments for Gonorrhea

Treatments for Gonorrhea

Key Takeaways

  • Gonorrhea is a preventable disease but can also be a serious condition.
  • Pregnant women who have gonorrhea may also pass the infection to their baby.
  • Antibiotics can successfully relieve symptoms and could cure gonorrhea infections given that the antibiotics are taken as prescribed. 

What types of medications are prescribed for gonorrhea?

Gonorrhea is a bacterial infection and sexually transmitted disease that is caused by Neisseria gonorrhoeae. People can get infected by having unprotected oral, vaginal, or anal sex. Sharing of contaminated sex toys can also transmit the disease. Gonorrhea is curable but can be a serious condition. Pregnant women who have gonorrhea may also pass the infection to their baby.

The usual recommended treatment for gonorrhea is the use of antibiotics administered as an injection. An antibiotic in tablet form can also be given. Antibiotics for the treatment of gonorrhea work by destroying the causative bacteria and stopping them from multiplying or replicating.

In the past, penicillin was used to treat gonorrhea as well as amoxicillin and ampicillin. Sadly, there has been an increase in the strains of penicillin-resistant gonorrhea through the years. That is why at present, newer antibiotics and antibiotic combinations are used to manage these resistant strains.

Antibiotics can successfully relieve symptoms and could cure gonorrhea infections given that the antibiotics are taken as prescribed. Normally, treatment starts after its diagnosis.

Below are the types of medications usually prescribed for the treatment of gonorrhea:

Azithromycin (Zmax, Zithromax)

This drug restricts bacterial growth, probably by blocking the dissociation of peptidyl-tRNA or transfer ribonucleic acid from ribosomes that cause RNA-dependent protein synthesis to seize. Azithromycin is part of the first line preference of dual-drug regimens for gonococcal infections including ceftriaxone IM. Azithromycin also helps in treating chlamydia infections, as both chlamydia and gonorrhea are common for people to simultaneously contract.

Ceftriaxone (Rocephin)

Along with azithromycin, ceftriaxone is part of the dual-drug regimen for the treatment of gonorrhea. The reason behind it is the success of high, sustained bactericidal levels found in the blood. This drug will bind to penicillin-binding proteins to inhibit the growth of bacterial cell walls.

Doxycycline (Doxy, Vibramycin)

This type of drug inhibits the synthesis of protein for the bacterial growth to bind to 30S and probably 50S ribosomal subunits of predisposed bacteria. Doxycycline can be taken orally at 100 mg twice a day for 10 to 14 days in addition to a single dose of 250 mg ceftriaxone IM for gonococcal epididymitis as well as pelvic inflammatory disease.

Cefixime (Suprax)

As a cephalosporin, cefixime inhibits the synthesis of bacterial cell wall by binding to one or more penicillin-binding proteins. Cefixime is not used as a first-line drug but it can be used as an alternative drug for uncomplicated gonorrhea in case ceftriaxone is not available. In this case, the patient is given a single oral dose of 400 mg cefixime and a single dose of 1 g azithromycin by mouth.

Erythromycin ophthalmic (Ilotycin)

This is the only antibiotic ophthalmic ointment that is recommended to use in neonates for prophylaxis of gonococcal ophthalmia neonatorum.

Oral Gonorrhea Treatment

The throat can be affected with gonorrhea infection and this can be more difficult to treat compared to the infection in the genital area. Even though the same type of antibiotics is recommended for the treatment of oral gonorrhea, the medications tend to be less helpful.

Disseminated Gonorrhea Treatment

Disseminated gonorrhea develops when the bacterium Neisseria gonorrhoeae spreads in the bloodstream. For this type of gonorrhea, hospitalization is needed during the first stage of treatment. Treatment usually includes ceftriaxone. About 1 g of ceftriaxone is given every day through an IV (intravenous) line.

If the patient with disseminated gonorrhea is allergic to ceftriaxone, other antibiotics can be given and they include:

  • 400 mg intravenous ofloxacin 
  • 50 mg intravenous ciprofloxacin 
  • 2 grams intramuscular spectinomycin every 12 hours

The first stage of treatment continues until the patient has shown signs of improvement no less than 24 to 48 hours. On the second stage of treatment, one of the following medications is needed to be taken for a minimum of one week:

  • 400 mg of ofloxacin twice a day
  • 500 mg of ciprofloxacin twice a day
  • 400 mg of cefixime twice a day

Treatment for Conjunctivitis

Conjunctivitis is a rare complication of gonorrhea that affects the eyes. It causes inflammation and swelling around the eyes. Also known as "pink eye", conjunctivitis causes the blood vessels in the outer lining of the eyes to be inflamed, resulting in red or pink-colored eyes. If conjunctivitis is due to a gonorrhea infection, ceftriaxone is the recommended antibiotic to take. One gram of ceftriaxone will be injected into the muscle. Aside from ceftriaxone, the affected eye or eyes must be thoroughly washed using a saline solution.

Treatment for Gonorrhea During Pregnancy

Pregnant women who have gonorrhea basically receive the same kind of treatment that is given to women who are not pregnant. The only exception is that the quinolone antibiotics such as ofloxacin and ciprofloxacin are not given to pregnant women because the said antibiotics inhibit the formation of DNA, and can cause birth defects. Two grams of spectinomycin is given to pregnant women who have allergies to cefixime or ceftriaxone. It is given as a single injection.

Are there home remedies for treating gonorrhea?

There are no home remedies for gonorrhea as it requires a prescribed antibiotic by a physician. Antibiotics can effectively help cure gonorrhea. There are various claims that certain home remedies can help with the treatment of gonorrhea, but none of them have been proven to be effective. Thus, it is still best to seek help from a medical professional to receive proper treatment.

How long does gonorrhea last?

Gonorrhea affects each individual differently because of different factors. Factors can include the person’s immune response and if the infection is resistant to antibiotics. That is why the incubation time of gonorrhea on each person is different.

The average incubation phase of gonorrhea in males is approximately 2-6 days. However, in some cases, the incubation period could take as much as 30 days. An asymptomatic (showing no symptoms) infection of gonorrhea can make the situation worse. If you have an asymptomatic infection and had sexual intercourse during the 30-day incubation period, you can transmit the infection to your partner.

In men, when gonorrhea starts to spread, complications such as epididymitis arise. Epididymitis is the swelling and inflammation of the epididymis, a convoluted duct where the sperm travels. Prostatitis or inflammation of the prostate gland may also be experienced by men with gonorrhea. Both epididymitis and prostatitis can affect a man’s ability to bear children. Thus, it is essential to seek medical help and treatment as soon as possible to avoid the long-term effects of gonorrhea.

On the other hand, gonorrhea in women could take a few days for the symptoms to start to appear. However, in some cases, just like in men, it could take 30 days before the symptoms begin to show. The early symptoms of gonorrhea in women could be mistaken for another condition like a bladder infection. Symptoms such as frequent urination, fever, fatigue, slight bleeding between periods, itching in the vaginal or anal region, and painful sexual intercourse can be experienced.

Unfortunately, newborns could also get gonorrhea. If the mother has vaginal gonorrhea during childbirth, the bacteria may be transferred to the infant’s eyes, which can result in pink eyes.

The incubation period in newborns usually lasts for a few days. When symptoms begin to appear, the infant’s eyes become watery and may produce a discharge. How long will the disease last in newborns? It varies. Typically, it would take a few weeks to heal. However, when treatment has already started, the infant is no longer contagious after 24 hours and is already on the road to recovery.

What happens if gonorrhea is not treated?

There is a possibility for complications to occur if gonorrhea is left untreated. Women usually develop a medical condition called pelvic inflammatory disease or PID. This condition happens when the infection spreads to the reproductive organs and can lead to sterilization. Men, on the other hand, could experience swelling of their penis and testicles. Both men and women could suffer from skin problems, arthritis, and other organ infections that are caused by the spread of gonorrhea in other parts of the body.

How to Prevent Gonorrhea

Gonorrhea is a preventable disease. There are important precautionary measures to take that can help put a stop to the spread of gonorrhea. Moreover, there are preventive measures that can help keep the infection from occurring in the first place.

The most dependable methods to prevent gonorrhea are:

  • Refraining from having sexual intercourse
  • Only have one sexual partner (one who is not infected and is sexually monogamous)
  • Use a reliable condom when having oral, vaginal, or anal sex

Given that gonorrhea does not usually cause symptoms, it is vital to get regularly tested, particularly when your partner is diagnosed with gonorrhea.

To lessen the risk of spreading or transmitting gonorrhea to other people, you must avoid any sexual contact for at least seven days after completing your treatment. Another way is to encourage the person or people you had sexual intercourse with over the past 60 days to get themselves self checked and tested.

If both partners have gonorrhea, both of them must abstain from having sexual intercourse until they are finished with their treatment and are cured.

Meanwhile, preventing gonococcal ophthalmia in newborns can be done. Pregnant women who are at risk of having gonorrhea must be tested during their first prenatal visit. If they are positive for gonorrhea, they should receive treatment. The test must be repeated for pregnant women who are at risk for infection during their third trimester.

Another preventive measure for gonorrhea is that newborns can be regularly treated at birth by giving them eye ointments or anti-infective eye drops.