Gonococcal Arthritis Medication

Updated: Jan 12, 2019
  • Author: Victoria Fernandes Sullivan, MD; Chief Editor: Herbert S Diamond, MD  more...
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Medication

Medication Summary

The goals of pharmacotherapy are to eradicate the infection, to reduce morbidity, and to prevent complications. Disseminated gonococcal infection (DGI) or gonococcal arthritis is treated with antibiotics.

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Antibiotics

Class Summary

Dual antibiotic regimens (preferably ceftriaxone plus azithromycin) are indicated for treatment of gonococcal infection.

The 2015 CDC recommendations for disseminated gonococcal infection are [17] :

Ceftriaxone 1 g IM/IV every 24 h plus a single dose of azithromycin 1 g PO

Alternative regimen - Cefotaxime 1 g IV every 8 h plus a single dose of azithromycin 1 g PO

When treating for the arthritis-dermatitis syndrome, the healthcare provider can switch to an oral agent guided by antimicrobial susceptibility testing 24-48 h after substantial clinical improvement, for a total treatment course of at least 7 days.

Ceftriaxone (Rocephin)

Ceftriaxone is the drug of choice for DGI or gonococcal arthritis, according to guidelines developed by the Centers for Disease Control and Prevention (CDC). It exerts its bactericidal action through inhibition of cell-wall synthesis. It has no activity against Chlamydia.

Azithromycin (Zithromax, Zmax)

Azithromycin inhibits bacterial growth, possibly by blocking the dissociation of peptidyl transfer ribonucleic acid (tRNA) from ribosomes, causing RNA-dependent protein synthesis to arrest. It is part of the first-line preferred dual-drug regimen for disseminated gonococcal infections plus ceftriaxone IM/IV.

Cefotaxime (Claforan)

Cefotaxime is a third-generation cephalosporin used as an alternative to ceftriaxone for treatment of DGI or gonococcal arthritis. It exerts its bactericidal action through inhibition of cell-wall synthesis.

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