Neisseria gonorrhoeae

Background

• Commonly known as gonorrhea
• Fastidious gram-negative cocci

Differential Diagnosis

• Sore Throat (DDx)

Management

• Proctitis
• Epididymitis
• Infectious Tenosynovitis
• Septic Arthritis (General)
• Orchitis
• Gonorrheal Conjunctivitis

Antibiotic Sensitivities

Antibiotics	'	N. gonorrhoeae
Penicillins	Penicillin G	0
	Penicillin V	0
Anti-Staphylocccal Penicillins	Methicillin	0
	Nafcillin/Oxacillin	0
	Cloxacillin/Diclox.	0
Amino-Penicillins	AMP/Amox	0
	Amox/Clav	+
	AMP-Sulb	+
Anti-Pseudomonal Penicillins	Ticarcillin	+
	Ticar-Clav	+
	Pip-Taxo	+
Carbapenems	Piperacillin	+
	Doripenem	+
	Ertapenem	+
	Imipenem	+
	Meropenem	+
	Aztreonam	+
Fluroquinolones	Ciprofloxacin	+*
	Ofloxacin	+*
	Pefloxacin	+*
	Levofloxacin	+*
	Moxifloxacin	+*
	Gemifloxacin
	Gatifloxacin	+*
1st G Cephalosporin	Cefazolin	+
2nd G. Cephalosporin	Cefotetan	+/-
	Cefoxitin	+/-
	Cefuroxime	+/-
3rd/4th G. Cephalosporin	CefoTAXime	+/-
	Cefizoxime	+/-
	CefTRIAXone	+
	Ceftobiprole	+
	Ceftaroline	+
	CefTAZidime	+/-
	Cefepime	+
Oral 1st G. Cephalosporin	Cefadroxil	0
	Cephalexin	0
Oral 2nd G. Cephalosporin	Cefaclor/Loracarbef	+/-
	Cefproxil	+/-
	Cefuroxime axetil	+/-
Oral 3rd G. Cephalosporin	Cefixime	+
	Ceftibuten	+/-
	Cefpodox/Cefdinir/Cefditoren	+
Aminoglycosides	Gentamicin	0
	Tobramycin	0
	Amikacin	0
	Chloramphenicol	+
	Clindamycin	0
Macrolides	Erythromycin	+/-
	Azithromycin	+/-
	Clarithromycin	+/-
Ketolide	Telithromycin	+
Tetracyclines	Doxycycline	+/-
	Minocycline	+/-
Glycylcycline	Tigecycline	+
Glyco/Lipoclycopeptides	Vancomycin	0
	Teicoplanin	0
	Telavancin	0
	Fusidic Acid	+
	Trimethoprim	0
	TMP-SMX	+/-
Urinary Agents	Nitrofurantoin	+
	Fosfomycin	+
Other	Rifampin	+
	Metronidazole	0
	Quinupristin dalfoppristin	+
	Linezolid
	Daptomycin	0
	Colistimethate	0

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

See Also

• STDs
• Microbiology (Main)