Note added about which patients are at increased risk of gram-negative enteric organisms.
Duration changed from 10 - 14 days to 10 days.
Ceftriaxone dose changed to 1g.
Sub-headings and antibiotic choices updated in line with BASSH and local expert advice.
New section for patients that are systemically unwell added.
Co-trimoxazole now 1st line for patients with low risk of STI, likely gram-negative organism.
Neisseria gonorrhoea, Chlamydia trachomatis, Gram negative enteric organisms
Patients at increased risk of gram-negative enteric organisms include: those with structural abnormalities of the urinary tract, recent urological surgery or instrumentation including urinary catheterisation, positive urine dipstick test, and men who have insertive anal sex.
10 days
IM or IV Ceftriaxone 1g single dose
+
Oral Doxycycline 100mg 12 hourly for 10 days
Oral Doxycycline 100mg 12 hourly for 10 days
Treatment for a positive gonorrhoea result should be based on microbiology sensitivities.
IM or IV Ceftriaxone 1g single dose
+
Oral Ofloxacin 400mg once daily for 10 days
Avoid ofloxacin in frail elderly patients where possible due to CDI risk. Check important safety information in BNF & give MHRA patient information leaflet to patient
Please contact duty microbiologist for further advice
Oral Co-trimoxazole 960mg twice daily for 10 days
Oral Ciprofloxacin 500mg twice daily for 10 days
Avoid ciprofloxacin in frail elderly patients where possible due to CDI risk. Check important safety information in BNF & give MHRA patient information leaflet to patient
Gentamicin IV (Hartford Regimen) as per guideline
Use calculator on app.
If reduced or unstable renal function, give single dose only then review with Infectious Diseases or Microbiology
+
If risk of STI,
IM or IV Ceftriaxone 1g single dose
Switch to oral antibiotic option when clinically stable. Use microbiology results or empirical options above.
Gentamicin IV (Hartford Regimen) as per guideline
Use calculator on app.
If reduced or unstable renal function, give single dose only then review with Infectious Diseases or Microbiology.
+
If risk of STI,
Oral Ciprofloxacin 500mg single dose
Switch to oral antibiotic option when clinically stable. Use microbiology results or empirical options above.
Ciprofloxacin: Avoid ciprofloxacin in frail elderly patients where possible due to CDI risk. Check important safety information in BNF and give MHRA patient information leaflet to patient.
Antimicrobial prescribing: NHS Grampian, Orkney & Shetland