Gonorrhea is treated with a single antibiotic injection. The standard treatment clears the infection within one to two weeks, and most people notice symptoms improving within a few days. Unlike many infections that require a full course of pills, uncomplicated gonorrhea is cured in a single clinic visit.
The Standard Treatment
The recommended treatment is a single injection of ceftriaxone, a powerful antibiotic given as a shot in the muscle, typically in the upper arm or buttock. The dose is 500 mg for people weighing under 300 pounds, and 1,000 mg for those 300 pounds or above. There’s no pill version of this treatment for gonorrhea. You’ll receive the injection at your provider’s office or a sexual health clinic, and that’s it. No follow-up prescriptions, no week-long pill regimen.
This single-shot approach exists for a practical reason: it guarantees you receive the full dose. With oral antibiotics, there’s always a risk of missed doses or not completing the course, which contributes to drug resistance. An injection eliminates that variable entirely.
What Recovery Looks Like
After the injection, symptoms like discharge, burning during urination, and pain typically begin improving within a few days. The infection itself clears within 7 to 14 days. During this window, you should avoid sexual contact to prevent passing the infection to a partner.
If your symptoms haven’t improved after a few days, or they get worse, contact your provider. This could signal a resistant strain or a co-infection with another STI, most commonly chlamydia. It’s common to be tested and treated for both at the same time, since the two infections frequently occur together.
Why Older Antibiotics No Longer Work
Gonorrhea has a long history of outsmarting antibiotics. The bacteria that cause it, known as the “superbug” of STIs, have developed resistance to nearly every drug class ever used against them. About 35% of gonorrhea samples tested through national surveillance show resistance to ciprofloxacin, a once-common oral treatment. That’s why it’s no longer recommended.
Ceftriaxone remains effective. Fewer than 0.1% of tested samples between 2019 and 2024 showed elevated resistance markers to the drug. But this number is watched closely. If resistance climbs, treatment options become extremely limited, which is why taking the full recommended dose matters even when it’s a single shot.
Getting Your Partners Treated
Anyone you’ve had sex with in the past 60 days needs to be tested and treated, even if they have no symptoms. This isn’t optional from a public health standpoint. Untreated partners will likely reinfect you after your treatment clears.
If your partner can’t or won’t visit a clinic, a strategy called expedited partner therapy allows your provider to write a prescription or provide medication that you physically bring to your partner, no separate appointment needed. This is legal in most states and is specifically designed for situations where a partner is unlikely to seek care on their own. It’s most commonly used for male partners of women diagnosed with gonorrhea.
What Happens If Gonorrhea Goes Untreated
Gonorrhea doesn’t resolve on its own. Left untreated, it can cause serious complications, particularly in women. An estimated 10% to 20% of untreated cervical gonorrhea infections progress to pelvic inflammatory disease (PID), an infection of the uterus, fallopian tubes, or ovaries. PID can cause chronic pelvic pain, ectopic pregnancy, and infertility. Even after treatment, one study found that 13% of patients still developed PID if treatment was delayed.
In men, untreated gonorrhea can lead to epididymitis, a painful infection of the tube that carries sperm, which can also affect fertility. In rare cases, the bacteria enter the bloodstream and spread to joints or other organs, causing fever, skin sores, and joint swelling that requires hospitalization.
Gonorrhea also increases your susceptibility to HIV. The inflammation it causes makes it easier for HIV to enter the body during sexual contact.
Gonorrhea During Pregnancy
The treatment is the same during pregnancy: a single ceftriaxone injection at the standard dose. Gonorrhea in pregnancy carries additional risks, including preterm delivery and transmission to the baby during birth, which can cause a serious eye infection in newborns. All pregnant individuals under 25, and those 25 and older with risk factors, are recommended for routine screening.
Who Should Be Tested Routinely
Many gonorrhea infections, especially in women and in throat or rectal infections, produce no symptoms at all. Screening catches what you wouldn’t notice on your own. Current guidelines recommend annual testing for:
- Sexually active women under 25
- Women 25 and older with risk factors like a new partner, multiple partners, inconsistent condom use, or a partner with an STI
- Men who have sex with men, at all sites of sexual contact (throat, rectum, urethra), regardless of condom use. Every 3 to 6 months if at higher risk
- People living with HIV, starting at initial evaluation and at least annually after
- Transgender and gender diverse individuals, based on anatomy and sexual practices
There’s no routine screening recommendation for heterosexual men at low risk, largely because they tend to develop noticeable symptoms (discharge, burning) that prompt them to seek care. But any man with symptoms or known exposure should be tested promptly.
Testing After Treatment
For uncomplicated cases treated with the recommended injection, a routine test of cure isn’t always necessary if symptoms resolve. However, retesting about three months after treatment is recommended to catch reinfection, which is common. If you were treated with an alternative regimen, or if your infection was in the throat (which is harder to clear), your provider may want to confirm the infection is gone with a follow-up test. Throat infections in particular can persist after treatment more often than genital infections.