Bibliographic information

GuidelineUpdated recommendations for the treatment of Neisseria gonorrhoeae, Chlamydia trachomatis, and Treponema pallidum (‎syphilis)‎ and new recommendations on syphilis testing and partner services.
Year of Publication2024
Issuing InstitutionWorld Health Organization

Recommendation

Updated

Retreating gonococcal infections after treatment failure. If treatment failure occurred after a non-WHO-recommended treatment, WHO suggests retreating with a WHO-recommended therapy. If reinfection is suspected, WHO suggests retreating with a WHO-recommended therapy, reinforcing the need for sexual abstinence, condom use and partner treatment. If treatment failure occurred and antimicrobial susceptibility testing data are available, WHO suggests retreating according to susceptibility profile. If treatment failure occurred after a WHO-recommended therapy and reinfection is assessed to be unlikely, WHO suggests retreating with a regimen not used previously from one of the following options and performing test of cure:

  • ceftriaxone 1 g intramuscularly as a single dose plus azithromycin 2 g orally, only

if ceftriaxone was not used previously;

  • spectinomycin 2 g intramuscularly as a single dose plus azithromycin 2 g

orally; or

  • gentamicin 240 mg intramuscularly as a single dose plus azithromycin 2 g orally

Recommended in favor

Conditional

Notes and Remarks

Remark

  • Retreatment should not be delayed. If an individual does not respond to thesetreatment failure recommendations, refer the individual to a specialist for furtherassessment and management.