rubyedward
Forum Elite
Topics: 12
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C. cetriaxone/or spectinomycin one shot IM
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| SDK
Forum Fanatic
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Ceftriaxone......
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| parmida
Forum Senior
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correct
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| Agrada
Forum Junior
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Tetracycline should be prescibed also.
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| ssrpk
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tetracycline is prescribed only if u suspect or want extre-coverage for chlamydia-trachomatis!
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| SDK
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I think for chlamydia trachomatis Metronidazole is usually prescribed along with single dose of cefriaxone in Gonorheal pts......while abt TC??
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| bactitech
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Please realize that many patients have both GC and Chlamydia at the same time. I believe our ER (and probably many others) always treat for both at the same time. We get more positive tests for Chlamydia than we do for GC.
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| chemamr
Moderator and PGY2
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though the question was only for gonorrheae, i guess the physician had a definitive diagnosis and had ruled out other causes. But i understand your point, Chlamydia is more common than Gonorrhea and they often coexist.
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| bactitech
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Many times the ER docs only have one shot at these patient so they empirically treat for both GC and chlamydia while the patient is available. Many of these patients will never follow up with a family physician. I work for a large city hospital and we get a lot of specimens from our ER to rule out STD's. Here is the URL from CDC that will give you more information:
http://tinyurl.com/8w264
This is the latest information on the subject.
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| chemamr
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thanks for the data 
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| p53
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For Neisseria gonorhoeae you can also use fluroquinolons. and yes, you must prescribe tetracycline for chlamidia at the same time.
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| bactitech
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Please note in the regimens listed above, Doxycycline must be taken 2 x day for 7 days. I'm sure many ER docs opt for the one BIG dose of Azithromycin over hoping these patients will take medication for a week. Quinolones also must be taken for a week. Many of these patients are noncompliant. You will see that once you do your ER rotations.
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