You got a positive gonorrhea test, or you have symptoms that feel a lot like it, and now you're searching to find out what actually makes it go away. The short, reassuring answer: gonorrhea is curable, and for most people the entire treatment is a single antibiotic shot at a clinic.
Still, there are real details worth getting right, from which drug is used to why an extra antibiotic is sometimes added and when you need a follow-up test. Here's a clear, evidence-based look at how gonorrhea is treated today.
What is the standard treatment for gonorrhea?
For an uncomplicated infection of the genitals, rectum, or throat, the only treatment the CDC recommends is a single intramuscular dose of the antibiotic ceftriaxone. The standard dose is 500 mg given as one injection for people who weigh under 150 kg. For people who weigh 150 kg (about 300 lbs) or more, the dose increases to a single 1 g intramuscular injection.
Ceftriaxone is given as a shot rather than a pill because it reliably reaches the levels needed to clear the bacteria. In most cases this single dose is the whole treatment. You don't take a course of pills at home for the gonorrhea itself.
Why is doxycycline sometimes added?
Gonorrhea and chlamydia often travel together, and the two infections need different antibiotics. Because of this, the CDC recommends adding doxycycline 100 mg by mouth twice daily for 7 days if a chlamydia infection has not been ruled out.
If your provider has already tested for chlamydia and excluded it, you typically only need the ceftriaxone shot. This is a meaningful change from older advice.
- Ceftriaxone single shot: treats the gonorrhea itself
- Doxycycline (7 days): added only when chlamydia coinfection hasn't been excluded
- Azithromycin: no longer part of the routine recommended regimen
What changed in the latest CDC guidelines?
In 2020, the CDC updated its gonorrhea treatment guidance in two important ways. First, it raised the recommended ceftriaxone dose from 250 mg to 500 mg. Second, it removed azithromycin from the routine recommended regimen.
Both changes were driven by antimicrobial stewardship and rising azithromycin resistance. In plain terms, gonorrhea bacteria have been getting harder to kill, so guidelines were tightened to keep the most reliable antibiotic working. If you were treated years ago, your regimen may have looked different from today's.
How long does gonorrhea treatment take to work, and do I need a follow-up test?
The antibiotic starts working right away, and symptoms such as discharge or pain often ease within a few days. To avoid passing the infection back and forth, you and any recent sexual partners should be treated, and you should avoid sex until everyone has completed treatment and symptoms have resolved.
Follow-up testing depends on where the infection is. A test of cure is generally not recommended for uncomplicated genital or rectal gonorrhea. For gonorrhea in the throat, though, a test of cure should be done 7-14 days after treatment using culture or a NAAT, because throat infections are harder to clear.
- Genital or rectal infection: routine test of cure usually not needed
- Throat (pharyngeal) infection: test of cure 7-14 days after treatment
- Symptoms persisting after treatment: go back to your provider
Should I worry about antibiotic-resistant gonorrhea?
You've probably seen headlines about "super gonorrhea," and resistance is a genuine concern. Gonorrhea has developed resistance to nearly every antibiotic ever used against it, and cephalosporins like ceftriaxone are now the last remaining recommended and effective class.
The reassuring part: the CDC reports no verified clinical cephalosporin treatment failures in the United States, and between 2019 and 2024 the share of monitored U.S. samples with elevated ceftriaxone resistance never exceeded 0.1%. The standard shot still reliably cures gonorrhea today. Following the full regimen and any recommended follow-up testing is how we keep it that way.
When should I see a doctor or seek urgent care?
Anyone who tests positive for gonorrhea, or who has symptoms like unusual discharge, burning with urination, or pelvic pain, should be evaluated and treated by a clinician. Gonorrhea cannot be safely treated at home without prescription antibiotics, and leaving it untreated can lead to complications such as pelvic inflammatory disease or epididymitis.
Seek prompt or emergency care if you have high fever, severe abdominal or pelvic pain, joint pain and swelling, or a new rash, which can signal the infection has spread beyond its original site. When in doubt, get checked rather than waiting it out.
Medical Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare provider before starting any new skincare treatment, especially if you have underlying health conditions, are pregnant, or are taking medications.
