Nelson Textbook of Pediatrics 22nd Edition | Gonorrhea: urethritis, cervicitis, pharyngitis, proctitis, pelvic inflammatory disease (PID), disseminated gonococcal infection (DGI) – arthritis-dermatitis syndrome, suppurative arthritis, endocarditis, meningitis. Ophthalmia neonatorum. Treatment: ceftriaxone (resistance concerns).
🌐 paeds.online — Pakistan's Pediatric Platform| Infection | Regimen | Notes |
|---|---|---|
| Uncomplicated urogenital, rectal, pharyngeal gonorrhea (adults/adolescents) | Ceftriaxone 500 mg IM (1 g if weight ≥150 kg) single dose | Do NOT use oral cephalosporins (cefixime) as first-line for pharyngeal gonorrhea. Treat Chlamydia co-infection with doxycycline 100 mg BID x7d. |
| Uncomplicated (children ≤45 kg) | Ceftriaxone 25-50 mg/kg IM (max 500 mg) single dose | Plus azithromycin (or doxycycline if ≥8 years) for Chlamydia co-infection. |
| Disseminated gonococcal infection (DGI) | Ceftriaxone 1 g IM/IV q24h for 7-14 days (at least 7 days) | Hospitalize. If meningitis or endocarditis, longer course (10-14 days meningitis, 28 days endocarditis). |
| Ophthalmia neonatorum | Ceftriaxone 25-50 mg/kg IV/IM single dose (max 125 mg) | Plus saline eye irrigation. Evaluate for disseminated disease. |
| Gonococcal conjunctivitis (older children/adults) | Ceftriaxone 1 g IM single dose + saline eye irrigation | Ophthalmology consult. |