DOH Reminds Pennsylvania Physicians of Treatment Changes for Uncomplicated Gonorrhea

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On Aug. 26, a summary of the 2015 treatment changes for uncomplicated gonorrhea was sent by the state Department of Health (DOH) to Pennsylvania physicians subscribed to receive its alerts through its PA Health Alert Network. The alert was a reminder of the Centers for Disease Control and Prevention’s 2015 STD Treatment Guidelines, issued in June 2015, which include several changes to the recommended treatment for uncomplicated gonorrhea infections.

The summary includes the following:

Recommended Regimen

  • Ceftriaxone 250 mg IM in a single dose PLUS
  • Azithromycin 1g orally in a single dose

Alternative Regimens
If ceftriaxone is not available:

  • Cefixime 400 mg orally in a single dose PLUS
  • Azithromycin 1g orally in a single dose

Special Notes:

  • A 400-mg oral dose of Cefixime should only be considered as an alternative cephalosporin regimen because it does not provide as high, nor as sustained, bactericidal blood levels as a 250-mg dose of ceftriaxone; further, it demonstrates limited efficacy for treatment of pharyngeal gonorrhea.
  • Use of ceftriaxone or cefixime is contraindicated in persons with a history of an IgE-mediated penicillin allergy.
    • Gentamicin 240 mg IM in a single dose PLUS
    • Azithromycin 2g orally in a single dose

Additional Information

DOH encourages Pennsylvania providers to review and become familiar with all of the recommendations contained in the revised 2015 CDC STD Treatment Guidelines, which are available at www.cdc.gov/std/treatment.

Physicians needing additional information regarding the changes to the 2015 CDC STD Treatment Guidelines are asked to call DOH’s Bureau of Communicable Diseases, Division of TB/STD, STD Program, at (717) 787-3981, between the hours of 8 a.m. and 5 p.m.

Reporting Requirements As a general reminder to providers, DOH requires electronic reporting of all diseases, infections, and conditions listed in 28 Pa. Code Chapter 27, Subchapter B (relating to reporting of diseases, infections, and conditions) through PA-NEDSS  (the online statewide electronic disease surveillance system).

For general information about NEDSS, go to www.health.pa.gov , keyword: PA-NEDSS.