Is a single ceftriaxone injection enough to cure gonorrhoea?

For uncomplicated urogenital, rectal and pharyngeal gonorrhoea, yes. Ceftriaxone 500 mg as a single intramuscular dose cures more than 95 percent of cases and is the current CDC, BASHH and WHO first-line. Older oral regimens including cefixime alone, single-dose azithromycin alone, and ciprofloxacin are no longer recommended because of rising resistance, particularly in Southeast Asia.

When can I have sex again after gonorrhoea treatment?

Abstain from all vaginal, anal and oral sex for 7 full days after the ceftriaxone injection, and until every recent partner has been tested and treated. If doxycycline 100 mg twice daily for 7 days has been added to cover chlamydia co-infection, both clocks run together, so the 7-day window applies.

Gonorrhoea Treatment in Patong, Phuket: Same-Day Ceftriaxone, NAAT and Discreet STI Care

Confidential gonorrhoea testing by NAAT with a single same-day ceftriaxone injection, partner notification support and a clear retest plan. Walk-in clinic or discreet hotel-room visit, day and night. Clinically reviewed by the Doctor Patong Takecare Clinic medical team.

Quick answer: Gonorrhoea is the second most common bacterial sexually transmitted infection worldwide, caused by Neisseria gonorrhoeae. Men usually develop urethritis with thick yellow-green discharge and burning on urination, while around half of infected women have no symptoms at all. We confirm the diagnosis with nucleic acid amplification testing (NAAT) on first-void urine or a self-collected swab, and treat the same hour with a single intramuscular dose of ceftriaxone 500 mg, the current CDC and WHO first-line. Throat and rectal sites are tested in anyone with oral or anal exposure, partners from the last 60 days are treated, and a retest at three months catches re-infection.

WhatsApp now for gonorrhoea testing and treatment | Call +66 81 718 9080 | Find the clinic on Google Maps

Gonorrhoea is one of the most frequent reasons patients message us in Patong after a new partner, a condom break, or a positive contact tracing alert. Men often arrive with a clearly symptomatic urethral discharge they want sorted before flying home, while many women and most patients with throat or rectal infection feel completely well and simply want to be sure. Our job is straightforward: confirm with a reliable NAAT at every relevant site, deliver the single ceftriaxone injection the same hour, guide partner notification in plain English and arrange the right test of cure. Everything stays inside a private consulting room, with results sent only by WhatsApp.

Cause, symptoms and why testing matters

Gonorrhoea is a bacterial infection of the genital, rectal, pharyngeal or conjunctival mucosa caused by Neisseria gonorrhoeae, a gram-negative diplococcus. It spreads through vaginal, anal and oral sex, and is often passed on by people who feel completely well. In men, urethritis is usually loud: a thick purulent yellow-green urethral discharge with significant dysuria (burning on urination) appearing two to seven days after exposure. In women, cervicitis is usually quiet, with around 50 percent of infections producing no symptoms at all, and the rest causing increased vaginal discharge, dysuria, intermenstrual bleeding or post-coital bleeding. Pharyngeal (throat) gonorrhoea is almost always asymptomatic and is particularly common in men who have sex with men, while rectal infection from receptive anal sex causes proctitis with anal pain, discharge or bleeding. Left untreated, gonorrhoea is a leading cause of pelvic inflammatory disease (PID) in women, which scars the fallopian tubes and raises the risk of infertility and ectopic pregnancy. Men can develop epididymo-orchitis, and either sex can develop disseminated gonococcal infection (DGI), a bloodstream spread that causes characteristic skin lesions, tenosynovitis and septic arthritis. Reactive arthritis and gonococcal conjunctivitis are further complications. Because so many infections are silent, the only way to know is to test.

Clinical insight: Gonorrhoea and chlamydia co-infection is common, so we usually test for both on the same sample and, where chlamydia has not yet been excluded, add doxycycline 100 mg twice daily for 7 days alongside the ceftriaxone shot. HIV and syphilis screening at the same visit is routine.

Diagnosis: NAAT by site of exposure

Diagnosis uses nucleic acid amplification testing (NAAT), a DNA-based test with very high sensitivity and specificity. The sample depends on where you may have been exposed. For most patients a first-void urine sample (the first part of the stream, not midstream) is the easiest option, and women can self-collect a vaginal swab in private with equal accuracy. Anyone reporting oral or anal sex needs site-specific throat and rectal swabs, because extra-genital infection is common, often missed by urine alone, and is the main reservoir driving antimicrobial resistance. Where antibiotic resistance is suspected or treatment has failed, we add a culture so the laboratory can test antibiotic susceptibility directly. Our internal link on STD testing in Patong covers the broader panel, including HIV, syphilis, hepatitis B and C.

Site of exposure	Sample we collect	First-line treatment
Urethral (men)	First-void urine NAAT, culture if resistance suspected.	Ceftriaxone 500 mg intramuscular, single dose.
Cervical / vaginal	Self-collected vaginal swab NAAT, or first-void urine.	Ceftriaxone 500 mg intramuscular, single dose.
Pharyngeal (throat)	Throat swab NAAT, repeat NAAT 7 to 14 days later as test of cure.	Ceftriaxone 500 mg intramuscular, single dose.
Rectal	Self-collected or clinician-collected rectal swab NAAT.	Ceftriaxone 500 mg intramuscular, single dose.
Penicillin or cephalosporin allergy	Same NAAT samples, plus culture.	Gentamicin 240 mg intramuscular plus azithromycin 2 g oral, single doses.

Treatment, partners and re-testing

The current CDC 2021 first-line treatment for uncomplicated urogenital, anorectal and pharyngeal gonorrhoea is ceftriaxone 500 mg intramuscular as a single dose, increased to 1 g for patients weighing more than 150 kg. Where chlamydia co-infection has not been excluded by NAAT, we add doxycycline 100 mg twice daily for 7 days, except in pregnancy where azithromycin 1 g single dose is substituted. For patients with a documented penicillin or cephalosporin allergy, the alternative regimen is gentamicin 240 mg intramuscular plus azithromycin 2 g oral, both single doses. Older regimens no longer reliably cure gonorrhoea and are not recommended: oral cefixime alone, single-dose azithromycin alone, and ciprofloxacin all show high or rising resistance, particularly across Southeast Asia. A test of cure by repeat NAAT at 7 to 14 days is recommended for pharyngeal infection because the throat is harder to clear and is the engine of resistance. Genital and rectal infections do not need a routine test of cure, but every patient is asked back for a re-test at three months because re-infection rates from untreated partners are high. Partner notification covers every sexual contact in the previous 60 days, or the most recent partner if longer, and all contacts are treated empirically even with a negative test because they are likely to be in the early window. We give you a neutral notification message you can forward by WhatsApp, or we contact partners anonymously on your behalf. Patients should abstain from all sex for 7 full days after the injection and until every partner has also been treated. The internal companion article on chlamydia treatment in Patong covers the co-infection regimen in more detail.

When to see a doctor

Test as soon as you have had a new or anonymous partner, a condom break, symptoms such as purulent discharge, urinary burning, post-coital bleeding, pelvic or testicular pain, anal pain or bleeding, or a message from a previous partner with a diagnosis. Routine STI screening including gonorrhoea is sensible at every change of partner, and at least every three to six months if you are on HIV pre-exposure prophylaxis (PrEP) or have multiple partners.

Red flag, see us the same day if you have any of these:

Severe lower abdominal or pelvic pain with fever, which may indicate pelvic inflammatory disease. One-sided lower abdominal pain with a missed or late period, which may indicate ectopic pregnancy, a surgical emergency. Painful one-sided testicular swelling, which may indicate epididymo-orchitis. A triad of small skin pustules, joint pain and tenosynovitis with fever, which can indicate disseminated gonococcal infection, including gonococcal septic arthritis. A red, swollen eye with purulent discharge after recent sexual exposure, which can be sight-threatening gonococcal conjunctivitis. Heavy rectal bleeding or severe anal pain with discharge.

See a doctor if:

You have any urogenital, throat or rectal symptoms, a known positive partner, or simply want a clean baseline before flying home. A short, private appointment confirms or rules out gonorrhoea and starts treatment the same hour. WhatsApp +66 95 073 5550 for a clinic slot or a hotel-room visit anywhere in Patong, Kalim, Kamala, Karon or Surin.

Prevention and early self-care

Consistent condom use during vaginal, anal and oral sex remains the single most effective protection against gonorrhoea and the rest of the bacterial STI panel. Regular screening is the second pillar, particularly at every new partner and at least every three to six months if you are on PrEP or have multiple partners. After a positive result, the most important self-care steps are accepting the single ceftriaxone injection, completing any added doxycycline course, abstaining from sex for at least 7 days and until every partner has been treated, and returning for a retest at three months. HIV pre-exposure prophylaxis protects against HIV but not gonorrhoea, so PrEP users are screened more often, not less.

Prevention point: The single most effective way to avoid a second gonorrhoea infection is to make sure every recent partner is tested and treated before you resume sex. We can help you draft a neutral notification message, or contact partners anonymously on your behalf, so the loop is closed and resistance is not driven further.

Summary

Gonorrhoea is common, often silent in women and at extra-genital sites, and cured the same day in almost every case with a single intramuscular ceftriaxone injection. A urine sample, self-collected vaginal swab or throat and rectal swabs confirm the diagnosis, partner notification protects you from immediate re-infection, and a three-month retest catches anything you pick up again. Untreated gonorrhoea carries serious long-term cost, particularly PID and tubal infertility in women, plus disseminated infection, so the case for a five-minute test is strong even when you feel completely well.

“Most gonorrhoea patients walk in well or with a single symptom, and leave with one swab, one injection and a clear retest date. The clinical work is short. The longer conversation is always about partners, abstinence for the next 7 days, and why we no longer use the oral antibiotics people remember from years ago.”
Doctor Patong Takecare Clinic medical team

Frequently asked questions

Can I have gonorrhoea without symptoms?

Yes, and it is the rule rather than the exception at some sites. Around half of cervical infections in women cause no symptoms at all, and pharyngeal (throat) infection is almost always silent. Men with urethral gonorrhoea are usually loud, with a thick yellow-green discharge and burning on urination, but rectal infection can be quiet too. Routine NAAT testing at every site of exposure is the only reliable way to know.

Do my partners need treatment if their test is negative?

Yes. All sexual contacts in the previous 60 days, or the most recent partner if it has been longer, are treated empirically with ceftriaxone 500 mg intramuscular, even with a negative NAAT. They are likely to be in the early window where the test cannot yet detect infection, and a single missed contact is the most common reason for a repeat positive a few weeks later.

Is a single ceftriaxone injection really enough?

For uncomplicated urogenital, rectal and pharyngeal gonorrhoea, yes. Ceftriaxone 500 mg as a single intramuscular dose cures more than 95 percent of cases, and is the current CDC, BASHH and WHO first-line. Where the patient weighs more than 150 kg, the dose is increased to 1 g. The older oral regimens, including cefixime alone, single-dose azithromycin alone, and ciprofloxacin, are no longer recommended because of rising antibiotic resistance, particularly in Southeast Asia.

Do I need a test of cure after treatment?

For pharyngeal (throat) gonorrhoea, yes: a repeat NAAT at 7 to 14 days after treatment is recommended because the throat is harder to clear and is the main driver of resistance. For genital and rectal infections, a routine test of cure is not required because cure rates are very high. Every patient is still asked back for a re-test at three months, because re-infection from an untreated contact is the most common reason for a second positive.

When can I have sex again?

Abstain from all vaginal, anal and oral sex for 7 full days after the ceftriaxone injection. You also need to wait until every recent partner has been tested and treated, otherwise re-infection is very likely. If we have added doxycycline 100 mg twice daily for 7 days to cover chlamydia co-infection, both clocks run together, so the 7-day window applies.

Should I be tested for other STIs at the same time?

Yes. Anyone diagnosed with gonorrhoea is offered same-visit screening for chlamydia, HIV and syphilis as standard, plus hepatitis B and C where risk applies. Co-infection with chlamydia is very common, and a new gonorrhoea diagnosis is a strong reason to update the full STI panel. Vaccination status for hepatitis B and HPV is also reviewed.

Sources

Centers for Disease Control and Prevention. Sexually Transmitted Infections Treatment Guidelines, 2021: Gonococcal Infections. cdc.gov/std/treatment-guidelines/gonorrhea.
British Association for Sexual Health and HIV (BASHH). UK national guideline for the management of gonorrhoea in adults. bashh.org/guidelines.
World Health Organization. Sexually transmitted infections (STIs) fact sheet. who.int/sti.

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