For treatment of uncomplicated Chlamydia use:
Azithromycin 1 gram po x 1 dose
For treatment of uncomplicated Gonorrhea use:
Ceftriaxone 250mg IV/IM x 1 dose (best, least resistance)
or
Cefixime 800 mg po x 1 dose (dramatically increasing resistance)
Please refer to a Health Canada alert from December 2011 that addresses the recommendation for the increased dose of Cefixime http://www.phac-aspc.gc.ca/std-mts/sti-its/alert/2011/alert-gono-eng.php Please note that because of the increasing resistance mentioned, Ceftriaxone is still recommended as the preferred choice.
Also, refer to this CDC document from August 2012, outlining that cefixime is no longer recommended in the US for treatment of GC. http://www.cdc.gov/nchhstp/newsroom/docs/2012/GonorrheaTreatmentGuidelinesFactSheet8-9-2012.pdf
Also, refer to this CDC document from August 2012, outlining that cefixime is no longer recommended in the US for treatment of GC. http://www.cdc.gov/nchhstp/newsroom/docs/2012/GonorrheaTreatmentGuidelinesFactSheet8-9-2012.pdf
** NOTE: it is recommended that you always also treat with Azithromycin because GC and Chlamydia often occur at the same time (even if it has not been proven via culture), and there is a theraputic effect of using both a cephalosporin and azithromycin together for GC (both above links address this).
In order for the patient and their partner to get the medication free of charge from the pharmacy,
write "Case K" for the index case (the person you have made the diagnosis on),
and "Case L" for the contact you are giving the other prescription for.
The MCH divisions of Infectious Diseases and Adolescent Medicine are currently working at coming up with a consensus on the treatment of STIs (mainly whether cefixime should no longer be used at all for this indication), stay tuned...
