Disseminated Gonococcal Infection (DGI) Guidelines – Closing the Clinical Knowledge Gap

Andrea Eberly, MD, MS, FAAEMEmergency Medicine, Family Medicine, Guideline Knowledge Check, Internal Medicine, Nurse Practitioner, Nursing RN/PN, Pediatric Emergency Medicine, Pediatric Medicine, Physician Assistant, Urgent Care

2021 disseminated gonococcal infection (DGI) Guidelines

Disseminated Gonococcal Infection Guidelines - Clinical Knowledge Gaps

What You Might Not Know About DGI Treatment Guidelines

In July 2021, the Centers for Disease Control and Preventions (CDC) published their updated guidelines on the management of sexually transmitted diseases including guidelines for disseminated gonococcal infection. How did the recommendations for treating disseminated gonorrhea change in July 2021?

Try this disseminated gonococcal infection case and see if you're following the most recent guidelines for DGI treatment.

A 22-year-old college student presents with a 5-day history of fever, joint pain, and rash.

On physical examination, his left knee and right wrist are warm, tender, and swollen to palpation.

He also has a few pustules on his hands and knees.

He says he had unprotected sex when he traveled to Hawaii a month ago.

A nucleic acid amplification (NAAT) test of his urine is positive for Neisseria gonorrhoeae but negative for Chlamydia trachomatis.


How has the treatment of the type of Neisseria gonorrhoeae infection present in the above patient changed from the last (2015) to the current (July 2021) CDC guidelines on sexually transmitted infections?

Answer Options:

Azithromycin was dropped from all recommended regimens for this type of gonococcal infection.

Azithromycin 2 gm orally as a single dose in combination with gentamicin 240 mg IM as a single dose is a new acceptable alternative to ceftriaxone therapy.

The frequency and dosing of ceftriaxone has changed from 1 gm every 24 hours to 1 gm every 12 hours.

The dosing of ceftriaxone has changed from 500 mg to 1gm per IM injection.

See the Answer:

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