🩺 General MedicineInfectious / STIStudentInternResident

Gonorrhoea & Urethral Discharge

Also known as: gonococcal infection · GC · urethral discharge syndrome

A sexually transmitted infection by Neisseria gonorrhoeae — urethral or vaginal discharge and dysuria, frequently co-existing with chlamydia. Rising antimicrobial resistance makes guideline-directed therapy essential.

Source · Reviewed 2026-08-15 · v1.0— AI-assisted draft — verify against the cited guideline before clinical use.

⚕️ Education only — not medical advice. Verify against the latest official guideline and your local protocol; confirm every drug dose against the cited source before clinical use.

Who gets it

Sexually active people; higher risk with multiple partners, another STI/HIV, and men who have sex with men.

Red flags — escalate / refer

Pelvic inflammatory disease, epididymo-orchitis, disseminated gonococcal infection (fever, arthritis, skin lesions), or ophthalmia neonatorum → urgent treatment.

Work-up / diagnosis

1NAAT (and culture for resistance where possible) from the appropriate site(s); syndromic diagnosis where labs are unavailable.
2Test for HIV, chlamydia and syphilis; take a sexual history and arrange partner notification.

Management — overview

Prompt guideline-directed antibiotics — typically a ceftriaxone-based regimen per national/programme guidance (which tracks resistance).
Empirically co-treat chlamydia.
Treat partners and advise abstinence until treated; manage as a national STI-programme condition; provide risk-reduction counselling and re-test as advised.

In-depthFull dosing & advanced protocol

Drug dosing

Ceftriaxone-based regimen (+ chlamydia cover)

Gonococcal infection

Adult dose: Per current national STI guidance
Route: IM / IV (+ oral for chlamydia)

Caution: Resistance is rising — follow current regimens; avoid outdated oral monotherapy.

NACONACO, India — National Guidelines for HIV Care & Antiretroviral Therapy ↗

Always co-treat chlamydia; watch resistance

Empirical chlamydia cover is standard.
Follow current national regimens — resistance has removed older oral options.
Treat partners and screen for other STIs; ophthalmia neonatorum is an emergency.

NACONACO, India — National Guidelines for HIV Care & Antiretroviral Therapy ↗

References

Guidelines change. If something here is out of date, tell us — we keep these current.

🚩 Report outdated / suggest update

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👤 Who gets it

🚩 Red flags — escalate / refer

🔎 Work-up / diagnosis

🧭 Management — overview

💊 Drug dosing

Ceftriaxone-based regimen (+ chlamydia cover)

📈 Always co-treat chlamydia; watch resistance

📚 References

More protocols

👤 Who gets it

🚩 Red flags — escalate / refer

🔎 Work-up / diagnosis

🧭 Management — overview

💊 Drug dosing

Ceftriaxone-based regimen (+ chlamydia cover)

📈 Always co-treat chlamydia; watch resistance

📚 References

More protocols

Who gets it

Red flags — escalate / refer

Work-up / diagnosis

Management — overview

Drug dosing

Always co-treat chlamydia; watch resistance

References

Who gets it

Red flags — escalate / refer

Work-up / diagnosis

Management — overview

Drug dosing

Always co-treat chlamydia; watch resistance

References