Gonorrhoea Treatment and Antibiotics, Explained

Gonorrhoea is curable. The way it is cured has changed, though, because the bacterium has become resistant to one antibiotic after another. That is why the treatment that works today is not the tablet a friend took ten years ago.

The treatment used now

The first-line treatment is ceftriaxone, given as an injection, usually as a single dose. Other options exist for people who cannot have it, such as those with a serious allergy, and the doctor chooses from those instead.

Chlamydia often travels with gonorrhoea. If it has not been ruled out, the doctor may treat for it at the same visit, which means a course of tablets alongside the injection.

Why the old antibiotics stopped working

Penicillin, tetracycline and ciprofloxacin all used to treat gonorrhoea. Resistance to each of them is now so common that none is relied on. Each time a new antibiotic became standard, resistant strains followed within years.

This is the main problem with antibiotics bought without a test. A tablet that is the wrong drug, or the right drug at the wrong dose, can quiet the symptoms without clearing the infection. You feel better, you are still infectious, and the bacteria that survive are the ones best at resisting treatment. Our Malay article on pharmacy gonorrhoea medicine goes into this in more detail.

Testing before treatment

Most people need a urine test. Throat and rectal swabs are added where the exposure points there, because urine testing alone misses infections at those sites. Where the organism needs to be identified, a culture with antibiotic sensitivities shows which drugs it still responds to.

What has to happen after the injection

• No sex for seven days after treatment, counted from the day treatment finishes, not from the day you feel better.
• Partners from the last 60 days need testing and treatment, whether or not they have symptoms. Sex with an untreated partner reinfects you.
• A test of cure a few weeks later for throat and rectal infections, and whenever symptoms do not settle.
• A repeat test at around three months, because reinfection is common.

Discharge and burning usually ease within a few days. If they have not, come back rather than waiting it out.

What happens if it is not treated

In women, gonorrhoea can spread to the womb and fallopian tubes and cause pelvic inflammatory disease, which can affect fertility. In men, it can cause painful swelling of the testicles. Rarely, it spreads through the bloodstream to the joints and skin. It can also pass to a baby during birth.

Treatment at Chye Clinic

Gonorrhoea and chlamydia are tested by PCR in the advanced STD profile at RM 225, which also covers HIV, syphilis and hepatitis. Treatment starts from RM 30 depending on what is found, and the price is given before anything is started. Symptoms, testing and treatment are covered in more depth on the gonorrhoea page.

This article is general information and does not replace an assessment by a doctor who knows your history.