Gonorrhea is treated with antibiotics, typically given as a single dose in one clinic visit. The standard treatment is an injection of ceftriaxone, a powerful antibiotic that kills the bacteria causing the infection. Most people are cured after this one treatment, but a follow-up test three months later is recommended to check for reinfection.
How the Standard Treatment Works
The first-line treatment for gonorrhea is a single intramuscular injection of ceftriaxone. You receive the shot at a clinic or doctor’s office, and that single dose is the entire course of treatment. There are no pills to take at home over several days. The antibiotic works by disrupting the bacterial cell wall, killing the gonorrhea-causing organism directly.
Because gonorrhea and chlamydia frequently occur together, your provider will likely test you for chlamydia at the same time. If chlamydia is detected or can’t be ruled out, you’ll also receive a course of oral antibiotics (typically taken for seven days) to cover that second infection. This dual approach is common, so don’t be surprised if you leave the clinic with a prescription in addition to the injection.
Why Antibiotic Resistance Matters
Gonorrhea has a long track record of developing resistance to antibiotics, which is why the recommended treatment has changed multiple times over the decades. Older antibiotics like ciprofloxacin are essentially useless against gonorrhea now. A 2023 surveillance study across nine countries found that 95.3% of gonorrhea samples were resistant to ciprofloxacin. Resistance to other antibiotics is climbing too: 8.9% of samples were resistant to cefixime (an oral antibiotic once used as a primary treatment), 3.8% were resistant to ceftriaxone, and 3.6% were resistant to azithromycin.
Those ceftriaxone resistance numbers are still relatively low, which is why it remains the go-to treatment. But the trend is concerning enough that researchers are actively developing new options. A phase 3 clinical trial published in The Lancet found that zoliflodacin, a new oral antibiotic, performed as well as ceftriaxone plus azithromycin for treating uncomplicated genital gonorrhea, with a similar safety profile. It works through a completely different mechanism than existing antibiotics, which means it could serve as a backup if resistance to ceftriaxone continues to grow. It’s given as a single oral dose, which would also eliminate the need for an injection.
What to Expect After Treatment
Most symptoms begin improving within a few days of the injection. Discharge, burning during urination, and pain should gradually resolve. You should avoid sexual contact for at least seven days after treatment and until your symptoms have fully cleared. If you have a partner who is also being treated, wait until they’ve completed their treatment as well.
You’ll need to get retested three months after treatment, regardless of whether you think your partner was successfully treated. This retest isn’t checking whether the antibiotic failed. It’s checking whether you’ve been reinfected, which is surprisingly common. If you can’t make that three-month appointment, the CDC recommends retesting whenever you next see a healthcare provider, as long as it’s within 12 months of treatment. Scheduling that follow-up visit on the same day you receive treatment makes it much more likely to actually happen.
If You Have a Drug Allergy
People with severe allergies to cephalosporin antibiotics (the drug class that includes ceftriaxone) need an alternative approach. Your provider will select a different antibiotic regimen based on the specific nature of your allergy and the site of infection. This is one situation where you genuinely need a provider’s guidance rather than a standard protocol, because the alternatives carry higher failure rates and the choice depends on your individual allergy history. Make sure to mention any known drug allergies before treatment begins.
Getting Your Partner Treated
Anyone you’ve had sexual contact with in the 60 days before your diagnosis needs to be tested and treated. This isn’t optional from a public health standpoint: untreated partners are the most common reason people get reinfected shortly after their own treatment.
If your partner can’t or won’t go to a clinic, a practice called expedited partner therapy (EPT) allows your healthcare provider to write a prescription that you physically deliver to your partner. Your partner takes the medication without being examined first. The CDC considers EPT a useful tool for partner management, particularly for male partners of women diagnosed with gonorrhea. The legal status of EPT varies by state, so your provider can tell you whether it’s an option where you live.
Infections in the Throat or Rectum
Gonorrhea doesn’t only affect the genitals. It can infect the throat (from oral sex) and the rectum (from anal sex), and these infections are often asymptomatic. Throat infections are notably harder to cure than genital infections. The same ceftriaxone injection is used, but throat gonorrhea clears less reliably, which makes the follow-up retest especially important if you had a pharyngeal infection. Rectal gonorrhea is treated identically to genital gonorrhea and generally responds well to the standard regimen.
If you’re being tested after a potential exposure, mention all types of sexual contact to your provider. A standard genital test will miss infections at other sites entirely. Throat and rectal infections require separate swabs.