Does Doxycycline Treat Gonorrhea? How Gonorrhea Is Treated
Quick answer
No. Doxycycline alone is not the recommended treatment for gonorrhea. In the United States the CDC recommends an antibiotic injection (ceftriaxone) given by a clinician. Doxycycline is used for chlamydia, which is often treated at the same time. Gonorrhea has developed resistance to several antibiotics, so take only what a clinician prescribes and go back for follow-up testing.
If you have been told you have gonorrhea, or you are thinking of taking leftover antibiotics, here is what the current US guidance says. This page describes how treatment works. It does not give doses, because a clinician sets those for you.
Does doxycycline treat gonorrhea?
Not as a stand-alone treatment. The CDC’s treatment guidelines recommend only one antibiotic for gonorrhea in the United States, an injection of ceftriaxone given by a clinician. Doxycycline is not the recommended gonorrhea treatment.
Doxycycline does have a role next to it. If chlamydia has not been ruled out, the CDC advises treating for chlamydia as well, and doxycycline is the medicine named for that. MedlinePlus notes that about half of women with gonorrhea also have chlamydia. So you may well be prescribed doxycycline when treated for gonorrhea, but alongside the injection, not instead of it.
Doxycycline belongs to the tetracycline family of antibiotics, according to MedlinePlus. The CDC states that gonorrhea strains circulating in the United States are not adequately susceptible to tetracycline, along with penicillin and older macrolides such as erythromycin.
How is gonorrhea actually treated?
The right treatment can cure gonorrhea, according to the CDC. For uncomplicated infections of the genitals, rectum or throat, it is an antibiotic injection from a clinician. The CDC also advises that gonorrhea medication be given on site and directly observed, so you leave treated.
Other options exist for people with a cephalosporin allergy or when the injection is not available, and a clinician chooses between them. The treatment for an eye infection, or one that has spread to the joints or blood, is different and needs specialist input. Do not share medicine with anyone, and do not treat yourself before you have been checked.
Why not just take a different antibiotic?
Because gonorrhea has developed resistance to several antibiotic groups. The CDC explains that cephalosporins are now the only remaining class of antibiotics recommended for gonorrhea in the United States. Drug-resistant strains are increasing, and the CDC says some gonorrhea is becoming harder to treat.
Earlier guidance recommended two antibiotics together, including azithromycin or doxycycline. The CDC now recommends ceftriaxone alone, partly because of concerns about harm to the microbiome from the second drug. Azithromycin on its own is no longer recommended, because resistance develops easily and treatment failures have been reported.
This is why taking leftover antibiotics, or the wrong one, is risky. It can leave the infection in place and add to resistance.
What happens after treatment?
- Avoid sex for seven days after treatment, and until your partners have also been treated and any symptoms are gone. This stops you passing it back and forth.
- Tell your recent partners. The CDC says partners from the last 60 days should be tested and treated.
- Go back if symptoms continue for more than a few days.
- Get other tests. People diagnosed with gonorrhea should be tested for chlamydia, syphilis and HIV, and you can order these online. If your HIV test is negative, a clinician may offer you PrEP.
- Retest at about three months. Reinfection is common, and most repeat positives are reinfections rather than failed treatment.
If you were treated for a throat infection, the CDC advises a test of cure 7 to 14 days after treatment. The throat is harder to clear than other sites, and few treatments cure it reliably. Genital and rectal infections treated with a recommended regimen do not need this extra test.
Will treatment undo any damage?
Medicine stops the infection but does not undo permanent damage that has already happened, such as scarring of the fallopian tubes. That is another reason to get tested early.
What about pregnancy?
If you are pregnant and have gonorrhea, the CDC advises seeing your provider for the right examination, testing and treatment as soon as possible, because treating early makes problems for the baby less likely. Pregnant people are treated with the injected antibiotic. Some options used for other people are cautioned against in pregnancy, so tell any clinician you are pregnant.
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Get care today if
- You have a fever, joint pain or swelling, or a bumpy or blotchy rash
- You have severe pain low in your belly or in your testicles
- Your eyes are red, painful or have pus that sticks to your eyelashes
- You are pregnant and think you may have gonorrhea
- You have hives, swelling of the face or lips, or trouble breathing after taking any antibiotic (call emergency services)
Call 911 for a medical emergency. Otherwise, urgent care or your doctor can see you today.
When to test
- Before treatmentOrder an online STD test first, usually a urine sample, with throat or rectal swabs if you have had oral or anal sex. A doctor or clinician then chooses the treatment.
- A few days after treatment, if symptoms continueGo back to your healthcare provider if symptoms last more than a few days after treatment. Further testing can check whether the bacteria are resistant.
- 7 to 14 days after treatment, if you had a throat infectionThe CDC advises anyone treated for gonorrhea in the throat to return for a test of cure. Testing this early can occasionally give a false positive, so your clinician may confirm a positive result before treating again.
- About 3 months after treatmentEveryone treated for gonorrhea should be retested around three months later, even if they believe their partners were treated.
Common questions
Can doxycycline cure gonorrhea?
It isn't a recommended treatment for gonorrhea. The CDC says only ceftriaxone, an injected antibiotic, is recommended for gonorrhea in the United States. Doxycycline is part of the tetracycline family, and CDC says gonorrhea strains circulating in the U.S. are not adequately susceptible to tetracycline.
Will doxycycline stop gonorrhea symptoms?
Do not rely on it. Because it is not a recommended gonorrhea treatment, it is not a dependable way to clear the infection, and untreated gonorrhea can cause serious and permanent health problems. See a clinician for a test and the recommended treatment.
Can azithromycin alone cure gonorrhea?
The CDC no longer recommends azithromycin on its own for gonorrhea, because the bacteria can develop resistance to this type of antibiotic and treatment failures have been documented. A clinician will decide what you need.
What if I am allergic to the injection?
The CDC lists alternative options for people with a cephalosporin allergy, or when the injection is not available. A clinician chooses which one, so tell them about any allergies before treatment.
Is doxycycline taken after sex the same thing?
No. Doxycycline taken after sex to try to prevent some bacterial infections is a separate topic, and it is not a treatment for gonorrhea. Ask a clinician about it if you are interested.
Sources
This guide is general information written by a patient advocate using public health sources. It is not a diagnosis. Only a clinician who examines you, or a lab test, can tell you what you have. Read how we write and check our guides.