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The choice of best antibiotics for gonorrhea can depend on several factors. These include an individual’s previous response to first line medications and the type of gonorrhea that is present. It also matters if individuals are simultaneously infected with chlamydia, which is not particularly uncommon. In these cases, more than one antibiotic may need to be tried.
As of 2007, the US Centers for Disease Control (CDC) published clear guides on how to choose the best antibiotics for gonorrhea. Shortly before this publication, studies indicated that one common group of antibacterial medicines, called floroquinolones, had begun to be ineffective and strains of the sexually transmitted disease were showing resistance to it. As it turns out, gonorrhea has behaved this way in the past with other antibiotics. It normally won’t respond to treatment with drugs like penicillin or tetracycline either.
The CDC issued recommendations for the best medications for gonorrhea based on this newly discovered resistance to floroquinolones, suggesting that people with simple cases of gonorrheal infection of the genitals receive a single intramuscular injection of ceftriaxone. This is a cephalosporin medication. Ceftriaxone is also indicated for treatment of gonorrhea that occurs in the throat, called pharyngeal gonorrhea.
If the illness is complicated by infection with chlamydia, a second oral antibiotic is typically added and this can be one of several types, and might include common drugs like Zithromax®. There are also a few medications very similar to ceftriaxone that are not available in the US, and these could make ideal substitutes. Additionally, if gonorrhea is a complicated infection, the initial injection could be followed with oral doses of antibiotics.
In some cases, ceftriaxone poses problems. Since is it a cephalosporin, some people are allergic to it if they are allergic to penicillin. An option is to look for the next best antibiotics for gonorrhea. Medications like doxycycline or clarithromycin could be used instead. Another approach is to use desensitization to the drug prior to giving it. Most times it isn’t necessary to do this, and other drugs will adequately substitute for it. It is known that drugs like Zithromax® will treat uncomplicated gonorrhea, but there exists concern that strains of gonorrhea will ultimately resist azithromycin, too.
A full examination and history of a patient's drug allergies is important in order to select the best antibiotics for gonorrhea. Doctors use guidelines but make decisions on case-by-case bases. These decisions may not always be identical to the guidelines. Furthermore, doctors need to continue to assess a patient’s recovery. Sometimes additional treatment is required even if the best and most recommended treatment has been used.