The new guideline calls on health authorities to advise doctors to prescribe whichever antibiotic would be most effective, based on local resistance patterns. The new WHO guidelines do not recommend quinolones (a class of antibiotic) for the treatment of gonorrhoea due to widespread high levels of resistance.
To cure syphilis, the new WHO guidelines strongly recommend a single dose of intramuscular (IM) benzathine penicillin.
Because people with this infection are frequently co-infected with gonorrhoea and treatment failures have been reported for tetracyclines and macrolides, the new guidance provides updates for first- and second-line treatment of the disease:
• azithromycin 1 g orally as a single oral dose
• doxycycline 100 mg orally twice a day for 7 days
or one of these alternatives:
• tetracycline 500 mg orally four times a day for 7 days
• erythromycin 500 mg orally twice a day for 7 days
• o oxacin 200–400 mg orally twice a day for 7 days.
The WHO is also calling on countries to start using the updated guidelines immediately, as recommended in the "Global Health Sector Strategy for Sexually Transmitted Infections (2016-2021)" endorsed by governments at the World Health Assembly in May 2016.