Neisseria gonorrhoeae

Background

Clinical Features

Differential Diagnosis
  • Sore Throat (DDx)
  • Pelvic Inflammatory Disease (PID)
  • Arthritis

Sexually transmitted diseases

Vesiculobullous rashes

Febrile

Afebrile

Evaluation

Workup
  • Dependent upon the infected organ
  • PCR or culture on Thayer-Martin agar (most common)

Management

Antibiotic Sensitivities[1]
Category Antibiotic N. gonorrhoeae
PenicillinsPenicillin G0
Penicillin V0
Anti-Staphylocccal PenicillinsMethicillin0
Nafcillin/Oxacillin0
Dicloxacillin0
Amino-PenicillinsAMP/Amox0
Amox-Clav+
AMP-Sulb+
Anti-Pseudomonal PenicillinsTicar-Clav+
Pip-Tazo+
CarbapenemsDoripenem+
Ertapenem+
Imipenem+
Meropenem+
Aztreonam+
FluroquinolonesCiprofloxacin+*
Ofloxacin+*
Levofloxacin+*
Moxifloxacin+*
Gemifloxacin
Gatifloxacin+*
1st G CephaloCefazolin+
2nd G CephaloCefotetan+/-
Cefoxitin+/-
Cefuroxime+/-
3rd/4th G CephaloCefotaxime+/-
Cefizoxime+/-
CefTRIAXone+
Ceftaroline+
CefTAZidime+/-
Cefepime+
Oral 1st G CephaloCefadroxil0
Cephalexin0
Oral 2nd G CephaloCefaclor+/-
Cefproxil+/-
Cefuroxime+/-
Oral 3rd G CephaloCefixime+
Ceftibuten+/-
Cefpodox/ Cefdinir/ Cefditoren+
AminoglycosidesGentamicin0
Tobramycin0
Amikacin0
Chloramphenicol+
Clindamycin0
MacrolidesErythromycin+/-
Azithromycin+/-
Clarithromycin+/-
KetolideTelithromycin+
TetracyclinesDoxycycline+/-
Minocycline+/-
GlycylcyclineTigecycline+
SulfonamidesTMP-SMX+/-
Urinary AgentsNitrofurantoin+
Fosfomycin+
OtherRifampin+
Metronidazole0
Quinupristin-dalfoppristin+
Linezolid
Daptomycin0
Colistimethate0
Telavancin0
Vancomycin0

Key
  • S susceptible/sensitive (usually)
  • I intermediate (variably susceptible/resistant)
  • R resistant (or not effective clinically)
  • S+ synergistic with cell wall antibiotics
  • U sensitive for UTI only (non systemic infection)
  • X1 no data
  • X2 active in vitro, but not used clinically
  • X3 active in vitro, but not clinically effective for Group A strep pharyngitis or infections due to E. faecalis
  • X4 active in vitro, but not clinically effective for strep pneumonia

Table Overview

Disposition
  • Depends on clinical features/presentation

See Also

References
  1. Sanford Guide to Antimicrobial Therapy 2010
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