Delivering a Healthy WA
Disease WAtch

New treatment guidelines for Neisseria gonorrhoeae

In 2012, 2,126 Western Australians were found to be infected with gonorrhoea. Since 2009, gonorrhoea notifications have more than doubled in the metropolitan area.

Gonorrhoea notifications in WA, 2009 to 2012

Gonorrhoea notifications in WA, 2009 to 2012

The emergence of multidrug-resistant Neisseria gonorrhoeae is a major public health concern worldwide. The USA's Centers for Disease Control and the British Association for Sexual Health and HIV have responded to the issue by changing their gonorrhoea treatment recommendations from ceftriaxone alone to ceftriaxone and azithromycin.

Western Australia is fortunate not to have multidrug-resistant Neisseria gonorrhoeae. To ensure these organisms do not become established in WA, the gonorrhoea treatment recommendations in WA Health's Guidelines for Managing Sexually Transmitted Infections (Silver Book) have been changed to include the addition of azithromycin.

Condition Treatment

Uncomplicated gonorrhoea contracted in the Perth metropolitan area; Great Southern, South West and Wheatbelt regions of WA; interstate; overseas; or where place of acquisition is not known.
OR
Anorectal or pharyngeal gonorrhoea

  • Ceftriaxone 500 mg in 2 mL 1% lignocaine intramuscularly
    AND
  • azithromycin 1 g (oral) given together as a single dose

Uncomplicated gonorrhoea contracted in the Goldfields, Kimberley, Pilbara or Midwest regions of WA*

  • amoxycillin 3g orally
    AND
  • probenecid 1g orally given together as a single dose

* A ZAP pack (azithromycin 1g, amoxycillin 3g and probenecid 1g single dose, directly observed therapy) should continue to be used for empirical treatment of uncomplicated gonorrhoea and/or chlamydia infections contracted in the Goldfields, Kimberley, Pilbara or Midwest regions of WA.

Antimicrobial surveillance is a vital public health measure so any patient with a purulent discharge who is suspected of having gonorrhoea should be swabbed for culture and antibiotic sensitivity testing.

Learn about the management of gonorrhoea and other sexually transmitted infections by visiting the Silver Book webpage.

For continuing professional development about managing sexually transmitted infections, visit Edith Cowan University's STI online learning program. The program is free and accredited with the Royal Australian College of General Practitioners and the Royal College of Nursing, Australia.

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