Infection	Recommended regimen
Adults
Uncomplicated urethral, cervical, or rectal gonococcal infection	Ceftriaxone (Rocephin), 250 mg IM in a single dose
		plus
	Azithromycin (Zithromax), 1 g orally in a single dose, or doxycycline, 100 mg orally twice per day for 7 days*
	If ceftriaxone is not available, use cefixime (Suprax), 400 mg orally in a single dose
		plus
	Azithromycin, 1 g orally in a single dose, or doxycycline, 100 mg orally twice per day for 7 days*
		plus
	Test of cure in one week
	For patients with severe cephalosporin allergy, use azithromycin, 2 g orally in a single dose
		plus
	Test of cure in one week
Disseminated gonococcal infection (hospitalization recommended)	Ceftriaxone, 1 g IM or IV every 24 hours until 24 to 48 hours after improvement begins
		or
	Cefotaxime (Claforan), 1 g IV every 8 hours until 24 to 48 hours after improvement begins
		or
	Ceftizoxime (Cefizox), 1 g IV every 8 hours until 24 to 48 hours after improvement begins 24 to 48 hours after improvement begins, switch to cefixime, 400 mg orally twice per day, for at least one week of total antimicrobial treatment
Gonococcal conjunctivitis	Ceftriaxone, 1 g IM in a single dose
Gonococcal meningitis and endocarditis	Ceftriaxone, 1 to 2 g IV every 12 hours for 10 to 14 days for meningitis and at least 4 weeks for endocarditis
Pharyngeal gonococcal infection	Ceftriaxone, 250 mg IM in a single dose
		plus
	Azithromycin, 1 g orally in a single dose, or doxycycline, 100 mg orally twice per day for 7 days*
Pregnant patients	Ceftriaxone, 250 mg IM in a single dose
	For patients with penicillin allergy, use azithromycin, 2 g orally in a single dose
Children
Urethral, cervical, rectal, or pharyngeal gonococcal infection	Children weighing > 45 kg (100 lb): same as adult recommendations
	Children weighing ≤ 45 kg: ceftriaxone, 125 mg IM in a single dose
Bacteremia or arthritis	Children weighing > 45 kg: ceftriaxone, 50 mg per kg IV or IM per day for 7 days
	Children weighing ≤ 45 kg: ceftriaxone, 50 mg per kg IV or IM per day (not to exceed 1 g per day) for 7 days
Neonates
Infants born to mother with untreated gonorrhea with no signs of infection	Ceftriaxone, 25 to 50 mg per kg IV or IM in a single dose, not to exceed 125 mg
Neonatal disseminated gonococcal infection or scalp abscess	Ceftriaxone, 25 to 50 mg per kg IV or IM per day for 7 days
		or
	Cefotaxime, 25 mg per kg IV or IM every 12 hours for 7 days
Neonatal meningitis	Ceftriaxone, 25 to 50 mg per kg IV or IM per day for 10 to 14 days
		or
	Cefotaxime, 25 mg per kg IV or IM every 12 hours for 10 to 14 days
Ophthalmia neonatorum	Ceftriaxone, 25 to 50 mg per kg IV or IM in a single dose, not to exceed 125 mg