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Table 7. Systemic Antibiotic Therapy for Gonococcal and
Chlamydial Conjunctivitis Footnotes
a
e Centers for Disease Control and Prevention (CDC) currently recommends that patients treated
for gonococcal infection also be treated routinely with a regimen effective against uncomplicated
genital Chlamydia trachomatis infection, because patients infected with Neisseria gonorrhoeae oen
are coinfected with C. trachomatis.
b
If ceriaxone is not available, cefixime 400 mg in a single dose or doxycycline 100 mg orally, twice a
day for 7 days may be used. Consider lavage of infected eyes with saline solution once.
c
A single oral dose of azithromycin 2 g is effective against uncomplicated gonococcal infections, but
the CDC does not recommend widespread use of azithromycin because of concerns over emerging
antimicrobial resistance to macrolides. Because data are limited regarding alternative regimens for
treating gonorrhea among persons who have severe cephalosporin allerg y, providers treating such
patients should consult infectious disease specialists.
d
Sexual abuse must be considered a cause of infection in preadolescent children. A diagnosis of
C. trachomatis or N. gonorrhoeae infection in preadolescent children should be documented by
standard culture.
e
e CDC recommends advising all women and men with chlamydial or gonococcal infection to be
retested approximately 3 months aer treatment.
f
Spectinomycin is not available in the United States; updated information from the CDC on the
availability of spectinomycin will be available at www.cdc.gov/std/treatment.
g
An association between oral erythromycin and infantile hypertrophic pyloric stenosis has been
reported in infants aged less than 6 weeks who were treated with this drug. Infants treated with
erythromycin should be followed for signs and symptoms of infantile hypertrophic pyloric stenosis.
NOTE. Pregnant women should not be treated with doxycycline, quinolones, or tetracyclines. Either
erythromycin or amoxicillin is recommended for treatment of chlamydia during pregnancy.
Data from: Centers for Disease Control and Prevention. Sexually transmitted diseases treatment
guidelines, 2010. MMWR Morb Mortal Wkly Rep 2010;59 (No. RR-12):44–55.
Update in: Centers for Disease Control and Prevention. Update to CDC's Sexually transmitted
diseases treatment guidelines, 2010. Oral cephalosporins no longer a recommended treatment for
gonococcal infections. MMWR Morb Mortal Wkly Rep 2012;61 (No. 31):590–4.
