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Therapeutic Approach

Gonorrhea is a sexually transmitted bacterial infection by Neisseria gonorrhoeae, a gram-negative intracellular bacteria visualized as pairs of cocci. Gonorrhea can be horizontally transmitted through oral, vaginal, and anal intercourse as well as vertically transmitted from mother to baby through an infected vaginal canal. Gonorrheal infections can often coexist with chlamydial infections so all patients with suspected gonorrhea should also be tested or empirically treated for chlamydia. Patients who have gonorrhea should abstain from sexual activity for 7 days after treatment. All sex partners should also be treated, including any sexual contact within the past 14 days for diagnosis. The Centers for Disease Control (CDC) have published recommended treatment guidelines and updated these guidelines in 2021 to reflect current trends in antimicrobial resistance. Treatment recommendations vary based on type of infection and age of patient. See Table 147-1.

Table 147-1Gonorrhea Treatment Table

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