Cefixime Treatment Guidelines

Uncomplicated Gonorrhea Treatment

• The CDC no longer recommends cefixime as first-line therapy for uncomplicated gonococcal infections due to rising resistance, particularly in the Western United States and among men who have sex with men 1, 2, 3
• If ceftriaxone is unavailable, the CDC recommends using cefixime 400 mg PLUS azithromycin 1 g orally as a single dose (preferred) OR doxycycline 100 mg twice daily for 7 days, with mandatory test-of-cure in 1 week 1, 3
• Cefixime has limited efficacy for pharyngeal gonorrhea and should be avoided for this site 1, 2

Combination Therapy for Gonorrhea

• The CDC recommends avoiding cefixime as monotherapy for gonorrhea, and instead combining it with azithromycin or doxycycline due to resistance concerns, and only using it when ceftriaxone is unavailable 1, 3