Group	Primary regimen		Alternative regimen		Considerations
A	Single dose of ceftriaxone (Rocephin), 250 mg intramuscularly, or single dose of cefixime (Suprax), 400 mg orally		—		Regimen covers Neisseria gonorrhoeae and Chlamydia trachomatis infections in addition to other common bacterial pathogens
		then
	Doxycycline, 100 mg orally twice daily for 10 days
B	Ciprofloxacin, 500 mg orally twice daily for 10 to 14 days		Trimethoprim/sulfamethoxazole, 160/800 mg orally twice daily for 10 to 14 days		Extend treatment for 2 weeks if patient remains symptomatic
		or
	Levofloxacin (Levaquin), 500 to 750 mg orally daily for 10 to 14 days
C	Ciprofloxacin, 400 mg IV every 12 hours		Ceftriaxone, 1 to 2 g IV every 24 hours		Continue treatment until patient is afebrile, then transition to oral regimen (group B) for an additional 2 to 4 weeks
		or		plus
	Levofloxacin, 500 to 750 mg IV every 24 hours		Levofloxacin, 500 to 750 mg IV every 24 hours
				or
			Piperacillin/tazobactam (Zosyn), 3.375 g IV every 6 hours
D	Piperacillin/tazobactam, 3.375 g IV every 6 hours plus aminoglycosides*		Fluoroquinolone (group C)		Continue treatment until patient is afebrile, then transition to oral regimen (group B) for an additional 2 to 4 weeks
				plus
		or	Aminoglycosides*
	Cefotaxime (Claforan), 2 g IV every 4 hours plus aminoglycosides*			or
		or	Ertapenem (Invanz), 1 g IV every 24 hours
	Ceftazidime (Fortaz), 2 g IV every 8 hours plus aminoglycosides*			or
			Imipenem/cilastatin (Primaxin), 500 mg IV every 6 hours
				or
			Meropenem (Merrem IV), 500 mg IV every 8 hours
E	Transrectal manipulation—fluoroquinolone resistance and extended spectrum beta-lactamase–producing Escherichia coli				Continue treatment until patient is afebrile, then transition to oral regimen (group B) for an additional 2 to 4 weeks
					Carbapenems can be used if patient is unstable
	Piperacillin/tazobactam, 3.375 g IV every 6 hours plus aminoglycosides*		Ertapenem, 1 g IV every 24 hours		If patient is stable, follow primary regimen while awaiting culture results
				or
			Imipenem/cilastatin, 500 mg IV every 6 hours
	Transurethral manipulation—Pseudomonas species
	Piperacillin/tazobactam, 3.375 g IV every 6 hours†		Fluoroquinolone (group C)†
		or		or
	Ceftazidime, 2 g IV every 8 hours†		Imipenem/cilastatin, 500 mg IV every 6 hours
		or		or
	Cefipime, 2 g IV every 12 hours†		Meropenem, 500 mg IV every 8 hours
	Fluoroquinolone exposure—fluoroquinolone resistance
	Piperacillin/tazobactam, 3.375 g IV every 6 hours†		Ceftriaxone, 1 g IV every 24 hours†
		or		or
	Ceftazidime, 2 g IV every 8 hours†		Ertapenem, 1 g IV every 24 hours
		or
	Cefepime, 2 g IV every 12 hours†