Pharyngitis - gonococcal

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Throat anatomy

Gonococcal pharyngitis

There are two parts to successfully treating a sexually transmitted disease, especially one as easily spread as gonorrhea. The first is to cure the affected person. The second is to locate, test, and treat all other sexual contacts to prevent further spread of the disease.

Mandatory reporting of gonococcal disease has been instituted and has, until recently, held the number of cases of gonorrhea at a low level. However, the incidence is once again rising, especially among men who have sex with men in large urban centers.

Beginning about the time of the Vietnam War, the United States saw the appearance of penicillin- and tetracycline-resistant strains of gonorrhea. In recent years, the incidence of fluroquinolone resistance in the gonococcus has also been rising.

Because of this, a new standardized treatment regimen has now been recommended by the CDC. Instead of the standard penicillin treatment, gonorrhea is now treated with newer antibiotics. As of 2006, the incidence of fluoroquinolone resistance in the U.S. has risen to the point that these agents are no longer considered first-line therapy.

This treatment regimen includes any one of the following antibiotics.

• INJECTIONS
  • Ceftriaxone IM (injected into a muscle)
• ORAL (by mouth) one-time dose
  • Cefixime
  • Cefpodoxime proxetil
  • Azithromycin 2g po x 1
• ORAL (by mouth) multiple dose
  • Erythromycin

In addition to treatment for gonorrhea, patients are usually treated at the same time for chlamydia. Chlamydia can be harder to diagnose, but may be found to cause infection at the same time.

A follow-up visit 7 days after treatment to recheck cultures and confirm the cure of infection is important.

Gonorrhea can be completely and quickly cured when diagnosed early and treated promptly before complications develop.

BOTH SEXES

• Disseminated gonococcemia
• Gonococcal arthritis

• Urethral scarring and stricture
• Epididymitis
• Orchitis
• Prostatitis

• Pelvic inflammatory disease
• Salpingitis
• Perihepatitis
• Infertility
• Sterility
• Increased incidence of tubal pregnancy (ectopic pregnancy)

Call your health care provider if you have had a known or suspected contact with an infected sexual partner.

Call your health care provider if you develop symptoms of gonococcal pharyngitis.

Review Date: 05/26/2006
Reviewed By: Monica Gandhi MD, MPH, Assistant Professor, Division of Infectious Diseases, UCSF, San Francisco, CA. Review provided by VeriMed Healthcare Network.