Antibiotics for Neisseria Gonorrhea

Cefixime as a single dose or Ceftriaxone plus amoxicillin or Azithromycin as a single dose are first choice treatments during pregnancy/lactation. If co-treatment for chlamydia is necessary, see section on chlamydia – pregnancy/lactation. Alternate treatment in pregnancy/lactation is Spectinomycin. Second choice treatments are Ceftriaxone and Azithromycin or Doxycycline. Doxycycline is not to be used during pregnancy (see chlamydia trachomatis section).

Cefixime (Suprax®)
Amoxicillin (Amoxil®, Polymox®, Trimox®)
Azithromycin (Zithromax®)

Neisseria Gonorrhea is a reportable infection and is the second most common sexually transmitted bacterial infection in Canada. The infection may occur in the cervix, fallopian tubes, rectum, throat and urethra. Many individuals are asymptomatic and are unaware of infection. Early symptoms may be mild and may be mistaken for a bladder or mild vaginal infection. Screening during pregnancy should occur at the first prenatal visit and if positive, a test of cure should be repeated at 3-7 days post antibiotic completion of treatment for pregnant and/or breastfeeding clients. Timely treatment reduces the risk of symptomatic infection with its associated risks. Repeat screening is recommended at 6 months if client is at high risk of reinfection. Partners also need to be informed, and advised to see their health care provider for assessment, screening and treatment.

Untreated gonorrhea can lead to complications in the reproductive organs including difficulty getting pregnant, ectopic pregnancy or pelvic inflammatory disease. The infection if untreated can be passed to newborns during birth and may lead to blindness if untreated.

Azithromycin (Zithromax®)