Gonorrhea (gonorrhea) is a classical sexually transmitted disease caused by infection with Neisseria gonorrhoeae (gonococcus) and manifests mainly as purulent inflammation of the mucous membranes of the genitourinary system. The most common manifestation in men is urethritis, while in women it is cervicitis. Local complications are mainly epididymitis and prostatitis in men, and endometritis and pelvic inflammatory disease in women. The pharynx, rectum and conjunctiva may also be the primary sites of infection. Blood-borne transmission of gonococci can lead to disseminated gonococcal infection (DGI), but this is rare clinically. (a) General principles: The principle of timely, adequate and regular medication should be followed; different treatment regimens should be used according to different conditions; follow-up should be conducted after treatment; sexual partners should be examined and treated at the same time. Advise patients to prohibit sexual intercourse until they and their sexual partners have completed treatment. Pay attention to multiple pathogen infections, generally anti-chlamydia drugs or routine testing for chlamydia trachomatis infection should be used at the same time, syphilis serology testing and HIV counseling and testing should also be done. (B) Treatment options: 1. Uncomplicated gonorrhea: 1) gonorrheal urethritis, cervicitis, proctitis recommended regimen: ceftriaxone 250 mg, single intramuscular injection; or daikonin 2 g (4 g for cervicitis), single intramuscular injection; if chlamydial infection cannot be ruled out, add anti-chlamydia trachomatis infection drugs. Alternatives: Cefotaxime 1 g, single intramuscular injection; or other 3rd generation cephalosporins, which have been shown to be more effective, may be chosen as alternatives. If chlamydial infection cannot be ruled out, add anti-chlamydia trachomatis infection; ②Children with gonorrhea: for those weighing > 45 kg, treat according to the adult regimen; for those weighing < 45 kg, treat according to the following regimen. Recommended regimen: Ceftriaxone 25 ~ 50 mg/kg (maximum adult dose not to exceed), single intramuscular injection; or Daikonin 40 mg/kg (maximum dose 2 g), single intramuscular injection. If chlamydial infection cannot be excluded, add anti-chlamydia trachomatis infection drugs. 2. Complicated gonorrhea: (1) gonorrheal epididymitis, prostatitis, seminal vesiculitis Recommended regimen: Ceftriaxone 250 mg, intramuscular injection once daily for 10 d; or Daikonin 2 g, intramuscular injection once daily for 10 d. If chlamydial infection cannot be ruled out, add anti-chlamydia trachomatis infection drugs. Alternative regimen: Cefotaxime 1 g, intramuscular injection once daily for 10 d. If chlamydial infection cannot be ruled out, add anti-chlamydia trachomatis drugs. (2) Outpatient treatment regimen for gonorrhea pelvic inflammatory disease: Ceftriaxone 250 mg by intramuscular injection once daily for 10 d. Add oral doxycycline 100 mg twice daily for 14 d. Add oral metronidazole 400 mg twice daily for 14 d. Recommended inpatient treatment regimen A: Cefotetan 2 g by intravenous infusion every 12 hours; or cefoxitin 2 g by intravenous infusion every 6 hours. every 6 hours, plus doxycycline 100 mg intravenously or orally every 12 hours. Note: If tolerated by the patient, doxycycline should be given orally if possible. Treatment with cefotetan or cefoxitin should not be given for < 1 week if the patient's condition permits. For clinical improvement within 72 h of treatment, consider discontinuing parenteral therapy at 1 week of treatment, if appropriate, and follow with oral doxycycline 100 mg twice daily plus oral metronidazole 500 mg twice daily for a total of 14 d. Recommended regimen for inpatient treatment B: clindamycin 900 mg intravenously every 8 hours plus a loading dose of gentamicin (2 mg/kg) intravenously or intramuscularly, followed by a maintenance dose (1.5 mg/kg) every 8 hours, or may be given once daily. Note: Parenteral therapy can be discontinued 24 h after the patient's clinical symptoms improve, followed by oral doxycycline 100 mg twice daily or clindamycin 450 mg four times daily for 14 d. Intravenous administration of doxycycline is painful and has no superiority over the oral route; tetracycline and doxycycline are contraindicated in women who are pregnant or lactating. Metronidazole should be avoided during the first 3 months of pregnancy. 3. Other sites of gonorrhea: (1) Recommended regimen for gonorrheal conjunctivitis: neonates: ceftriaxone 25-50 mg/kg (total not to exceed 125 mg), intravenous or intramuscular injection, once daily for 3 d. Children: adult regimen for those weighing > 45 kg, children weighing < 45 kg: ceftriaxone 50 mg/kg (maximum dose 1 g), single intramuscular injection or Intravenous drip. Adults: Ceftriaxone 1 g as a single intramuscular injection. The eyes should be flushed with physiological sodium chloride solution once every hour. Daikonomycin should not be applied to newborns. The mother of the newborn should be examined and if she has gonorrhea, treated at the same time. The newborn should be hospitalized and checked for disseminated infection. (2) Recommended regimen for gonorrhea: Ceftriaxone 250 mg, single intramuscular injection; or cefotaxime 1 g, single intramuscular injection. If chlamydial infection cannot be ruled out, add anti-chlamydia trachomatis infection drugs. Note: Because of the poor efficacy of Daguanomycin in gonorrhea, it is not recommended. 4. Disseminated gonorrhea: (1) Recommended regimen for disseminated gonorrhea in newborns: Ceftriaxone 25-50 mg?kg-1?d-1, intravenous or intramuscular injection once daily for 7-10 d. In case of meningitis, the course of treatment is 14 d. (2) Disseminated gonorrhea in children: For those weighing > 45 kg, treat according to the adult regimen; for children weighing < 45 kg, treat according to the following regimen. Recommended regimen: Gonococcal arthritis: Ceftriaxone 50 mg/kg intramuscularly or intravenously once daily for 7-10 d; Meningitis or endocarditis: Ceftriaxone 25 mg/kg intramuscularly or intravenously twice daily for 14 d (meningitis) or 28 d (endocarditis). (3) Adult disseminated gonorrhea: Hospitalization is recommended. Examination for endocarditis or meningitis is required. If chlamydial infection cannot be ruled out, anti-chlamydia trachomatis infection drugs should be added. Recommended regimen: Ceftriaxone 1 g, intramuscularly or intravenously once daily for ≥ 10 d. Alternative regimen: Daikonomycin 2 g, intramuscularly twice daily for ≥ 10 d. In gonococcal arthritis, open drainage is contraindicated except in the hip joint, but repeated aspiration is possible and intra-articular antibiotic injections are prohibited. The duration of treatment for gonococcal meningitis is about 2 weeks and for endocarditis >4 weeks. 5. Recommended regimen for infection during pregnancy: Ceftriaxone 250 mg, single intramuscular injection; or Daikonin 4 g, single intramuscular injection. If chlamydial infection cannot be ruled out, add anti-chlamydia trachomatis infection drugs, tetracyclines and quinolones are prohibited.