Medication Summary
The goals of pharmacotherapy are to eradicate the infection, to reduce morbidity, and to prevent complications. Gonococcal arthritis and disseminated gonococcal infection are treated with antibiotics.
Antibiotics
Class Summary
Dual antibiotic regimens (preferably ceftriaxone plus azithromycin) are indicated for treatment of gonococcal infection.
Ceftriaxone (Rocephin)
Ceftriaxone is the drug of choice for disseminated gonococcal infection 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. Azithromycin plus ceftriaxone constitutes the first-line preferred dual-drug regimen for disseminated gonococcal infections.
Cefotaxime (Claforan)
Cefotaxime is a third-generation cephalosporin used as an alternative to ceftriaxone for treatment of disseminated gonococcal infection or gonococcal arthritis. It exerts its bactericidal action through inhibition of cell-wall synthesis.
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Synovial joint.
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The lesion on this patient's heel was due to the systemic dissemination of the N gonorrhoeae bacteria.
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The foot of this patient is swollen due to gonococcal arthritis.
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This patient presented with cutaneous foot lesions that were diagnosed as a disseminated gonococcal infection.
