For adults and adolescents (including pregnant women) with genital, anorectal and/or oropharyngeal gonococcal infections, WHO suggests:

• ceftriaxone 1 g intramuscularly as a single dose.

If ceftriaxone is not available or refused, WHO suggests:

• cefixime 800 mg orally and performing test of cure.

If test of cure is not possible or when oropharyngeal infection is diagnosed or is a potential concern, WHO suggests:

• cefixime 800 mg orally plus azithromycin 2 g orally.

When resistance, allergy or availability of cephalosporins is a concern, WHO suggests one of the following options:

• spectinomycin 2 g intramuscularly as a single dose plus azithromycin 2 g

orally; or

• gentamicin 240 mg intramuscularly as a single dose plus azithromycin 2 g orally