Halton Region Public Health: Office of the Medical Officer of Health
Quick facts
- The National Advisory Committee on Sexually Transmitted and Blood-Borne Infections (NAC-STBBI) has issued new guidance for treating uncomplicated gonococcal infections (i.e., urogenital, rectal, and pharyngeal) for patients 10 years of age and older.
- The preferred treatment is now Ceftriaxone 500 mg IM as a single dose (monotherapy). This replaces the previous preference for combination therapy (e.g., Ceftriaxone 250 mg IM + Azithromycin 1g PO).
- Two 250 mg vials are needed to administer the recommended 500 mg dose. Of note, 500 mg vials of Ceftriaxone are not currently available in Canada.
- To order publicly funded STI medications, please visit halton.ca.
Key messages for healthcare providers
- Alternative treatment options are currently under review by NAC-STBBI. Please consult PHAC’s Gonorrhea Guidance (external link) for updates.
- For patients where chlamydia infection has not been ruled out with a negative test, concurrent treatment for chlamydia should also be offered as per PHAC’s Chlamydia and LGV Guidance (external link).
- A Test of Cure (TOC) is recommended for all cases of gonorrhea at all positive sites, the specifics of which depend on timing after treatment completion and patient’s symptom status.
- If a test of cure is done 3 to 21 days after treatment completion, a culture is recommended regardless of the patient’s symptom status.
- If a test of cure is done after 21 days from treatment completion and the patient is:
- Asymptomatic – NAAT is recommended
- Symptomatic – Both Culture and NAAT are recommended.
- Repeat screening continues to be recommended six months post treatment for all cases.