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thral discharge
Treatment of the patient
– In m en:
• If m icroscopy of a ureth ral sm ear h as been perform ed : in th e absence of g onococci,
treat for ch lam yd ia alone; in th e presence of g onococci, treat for ch lam yd ia AN D
g onorrh oea.
• W h en no laboratory is av ailable, treat for ch lam yd ia AN D g onorrh oea.
– In wom en:
T reat for ch lam yd ia AN D g onorrh oea.
Men and non-pregnant women
Treatment for chlamydia Treatment for gonorrhoea
azithromycin P O : 1 g as a sing le d ose PLUS cefixime P O : 400 m g as a sing le d ose
or or
doxycycline P O : 200 m g /d ay in ceftriaxone IM : 250 m g as a sing le d ose
2 d iv id ed d oses for 7 d ays or
spectinomycin IM : 2 g as a sing le d ose
Pregnant women
azithromycin P O : 1 g as a sing le d ose PLUS cefixime P O : 400 m g as a sing le d ose
or or
erythromycin P O : 2 g /d ay in ceftriaxone IM : 250 m g as a sing le d ose
2 or 4 d iv id ed d oses for 7 d ays
If ureth ral d isch arg e persists or reappears after 7 d ays:
– V erify th at th e patient h as receiv ed an effectiv e treatm ent (i.e. one of th e
com binations abov e).
– Gonococcal resistance is a possibility if anoth er treatm ent (e.g . cotrim oxazole or
kanam ycin) h as been ad m inistered : re-treat for g onorrh oea as abov e (ch lam yd ia is
rarely resistant).
– If an effectiv e antibiotic th erapy h as been g iv en, consid er trich om oniasis ( tinidazole or
metronidazole P O , 2 g as a sing le d ose); also consid er re-infection.
Treatment of the partner
T h e sexual partner receiv es th e sam e treatm ent as th e patient, w h eth er or not
sym ptom s are present.
232
Treatment of the patient
– In m en:
• If m icroscopy of a ureth ral sm ear h as been perform ed : in th e absence of g onococci,
treat for ch lam yd ia alone; in th e presence of g onococci, treat for ch lam yd ia AN D
g onorrh oea.
• W h en no laboratory is av ailable, treat for ch lam yd ia AN D g onorrh oea.
– In wom en:
T reat for ch lam yd ia AN D g onorrh oea.
Men and non-pregnant women
Treatment for chlamydia Treatment for gonorrhoea
azithromycin P O : 1 g as a sing le d ose PLUS cefixime P O : 400 m g as a sing le d ose
or or
doxycycline P O : 200 m g /d ay in ceftriaxone IM : 250 m g as a sing le d ose
2 d iv id ed d oses for 7 d ays or
spectinomycin IM : 2 g as a sing le d ose
Pregnant women
azithromycin P O : 1 g as a sing le d ose PLUS cefixime P O : 400 m g as a sing le d ose
or or
erythromycin P O : 2 g /d ay in ceftriaxone IM : 250 m g as a sing le d ose
2 or 4 d iv id ed d oses for 7 d ays
If ureth ral d isch arg e persists or reappears after 7 d ays:
– V erify th at th e patient h as receiv ed an effectiv e treatm ent (i.e. one of th e
com binations abov e).
– Gonococcal resistance is a possibility if anoth er treatm ent (e.g . cotrim oxazole or
kanam ycin) h as been ad m inistered : re-treat for g onorrh oea as abov e (ch lam yd ia is
rarely resistant).
– If an effectiv e antibiotic th erapy h as been g iv en, consid er trich om oniasis ( tinidazole or
metronidazole P O , 2 g as a sing le d ose); also consid er re-infection.
Treatment of the partner
T h e sexual partner receiv es th e sam e treatm ent as th e patient, w h eth er or not
sym ptom s are present.
232
