How is gonorrhea ("the clap") treated?

The following information describes the typical treatment approach in Germany. You may find that things are different elsewhere.

Gonorrhea bacteria can be killed with antibiotics. A single dose of ceftriaxone is typically given through a drip (infusion), but it may be injected into a muscle instead – usually the buttocks. On top of that, some people are given an azithromycin tablet too. But you might not need to take the tablet, depending on what your doctor says. After two to four weeks, you go back to the doctor's to see if the treatment has worked.

The treatment normally gets rid of the gonococcus bacteria within 24 hours. Experts believe that ceftriaxone is effective in the vast majority of people who have an uncomplicated gonorrhea infection in their throat, genital area or around their anus. This medication is also considered to be well tolerated. The possible side effects include skin rashes, digestive problems and (in rare cases) allergies.

Pregnant women who have gonorrhea can use antibiotics too – the same ones that other people use.

Babies who are infected during childbirth are also given antibiotics. They typically receive a ceftriaxone drip or injection as well.

Antibiotics are also used if the bacteria have spread to the internal sex organs (ascending infection) or if they’ve caused inflammation in other parts of the body.

The treatment takes longer if these types of complications occur – often up to two weeks. A combination of at least two antibiotics is typically used. Depending on where the infection has spread to and how severe it is, you’ll be given extra antibiotics on top of the usual ones. For example, doxycycline or metronidazole might be prescribed if you have pelvic inflammatory disease (PID).

Gonorrhea is one of the infectious diseases that have seen a worldwide increase in antibiotic resistance. Many antibiotics no longer work because the bacteria have become resistant to them. Only relatively few types (strains) of gonococcus bacteria are resistant to ceftriaxone. In Germany, the figure is assumed to be less than 0.5%. So ceftriaxone can usually be prescribed even if it’s not completely clear which gonococcus strain is causing the infection.

If ceftriaxone doesn't work or can’t be used due to an allergy, doctors can do a test to see what other antibiotics can be used: Bacteria are taken from a sample of infected tissue and then grown in a lab, where they are exposed to various types of antibiotics. This is called a sensitivity (or susceptibility) test. If possible, it should be done before treatment so the doctor can choose a suitable antibiotic rather than “blindly” prescribing ceftriaxone.

To keep on top of the resistance situation in Germany, laboratories have to inform the Robert Koch Institute whenever antibiotics that are usually effective (like ceftriaxone or azithromycin) don't work. But they won’t pass on the name of the person with gonorrhea. Apart from that, gonorrhea cases don’t have to be reported to the authorities in Germany – except for in the state of Saxony.