Compliance can be improved by providing clear written information. 21 days Disseminated gonococcal infection usually requires hospital admission. Consultation with an infectious diseases physician is recommended. Single dose regimens using fluoroquinolones, third generation and extended spectrum cephalosporins or spectinomycin have been found to be safe and generally well tolerated. Single dose regimens increase compliance.
Limited evidence suggests that non-quinolone treatments in pregnancy are safe and effective.
Although no adverse effects of quinolones on pregnancy outcomes have yet been reported, there are theoretical risks of arthropathy. Quinolones in pregnancy are therefore generally not advised. A single 2 g dose of azithromycin has been shown to be effective in treating gonococcal cervicitis but is expensive, causes gastrointestinal irritation, and is of unproven efficacy in treating extragenital infection. It is not currently recommended for routine use. 500 mg tds for 10 days have both been shown to be as effective as doxycycline in treating coexistent chlamydial infection.