Therapy for gonococcal infections: options in 1989.

The choice of therapy for Neisseria gonorrhoeae infections is complicated by antibiotic resistance and by the varying efficacy of some antibiotics at different anatomic sites of infection. Ceftriaxone (a single intramuscular dose of 250 mg) is a simple, effective, and generally well-tolerated choice for uncomplicated N. gonorrhoeae infection at all anatomic sites. Alternatives include single-dose oral regimens of ciprofloxacin, norfloxacin, and cefuroxime axetil as well as single-dose intramuscular regimens of spectinomycin, ceftizoxime, and cefotaxime. The addition of doxycycline (100 mg orally twice a day for 7 days) is recommended for presumptive treatment of chlamydial coinfection. Tetracyclines should not be used as sole therapy for gonococcal infection because of gonococcal resistance.