Updated Gonorrhea Treatment Guidance
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To: Local Health Care Providers
Background
The Public Health Agency of Canada has revised guidelines for Neisseria gonorrhoeae (NG) infection treatment in the Canadian Guidelines for Sexually Transmitted Infections, following interim guidance by the National Advisory Committee on Sexually Transmitted and Blood-Borne Infections (NAC-STBBI). There is no longer Ontario-specific gonorrhea treatment guidance, and previous guidance has been removed from the Public Health Ontario website.
Updated treatment guidance
Preferred treatment for uncomplicated NG infection (i.e., urethral, endocervical, vaginal, rectal, and pharyngeal infections) is Ceftriaxone 500 mg IM as a single dose (monotherapy).
Refer to the Public Health Agency of Canada’s Gonorrhea Guide for details about alternative treatment options.
Notes:
- If C. trachomatis infection has not been excluded by a negative test, concurrent treatment for chlamydia is recommended. Refer to the Chlamydia and LGV Guide for more information.
- A test of cure (TOC) is recommended for all positive NG sites in all cases. Refer to the test of cure section in the Gonorrhea Guide for more information.
- The guidance also recommends NG culture together with nucleic acid amplification testing (NAAT) in cases of suspected treatment failure, symptomatic individuals, pregnant people, contacts of cases with NG infection, sexual abuse/sexual assault, and acquisition of infections in areas with high rates of antimicrobial resistance. Refer to the NAC-STBBI interim guidance for more information.
Reporting to Public Health
Gonorrhea and other diseases of public health significance must be reported to the Medical Officer of Health by faxing or emailing the communicable disease notification form (PDF, 210 KB) to 705.677.9618 or HPT_Fax_Confidential@phsd.ca.
To order medications, complete the STI Medication Order Form (PDF) and fax it to 705.677.9611. You will be notified once the medications are ready to be picked up.
If you have any questions, please contact the Sexual Health Clinic at 705.522.9200, ext. 482 (toll-free 1.866.522.9200) or send an email to sexualhealthnoc@phsd.ca, Monday to Friday, 8:30 a.m. to 4:30 p.m., or after-hours and on weekends at 705.688.4366.
Sincerely,
Original Signed By
Emily Groot, MD, MPH, FRCPC (she/her)
Associate Medical Officer of Health