Brief Answer:
Alternatives and their pros and cons explained. Capsules should not be opened- details below

Detailed Answer:
Hello and welcome to Ask a Doctor service,

I carefully read your query and understand your concern.

The best treatment for gonorrhea is an injection of Ceftriaxone plus a single oral dose of 1g azithromycin.
In patients that are not able to get injections, oral treatment can be given but this is not the optimal treatment.

The oral treatment (instead of injectable ceftriaxone plus oral azithromycin) would be:

1. cefixime 800 mg orally in a single dose PLUS Azithromycin 2 g orally in a single dose

2. if the patient had a culture of the secretions and it determined to be susceptible to one of these, then the patient may take one of these:
- ciprofloxacin 500 mg orally in a single dose
- ofloxacin 400 mg orally in a single dose
- azithromycin 2 g orally in a single dose

So, to conclude:

- there are treatments that can be taken only orally but these are not the optimal and best treatment and in some cases, a culture of the secretions is needed to prove their efficacy.

- please note that today gonorrhea infection is mostly diagnosed with a test called NAAT and not with culture. In cases a culture will be done, this may take a few days before the results are ready, and this may delay the treatment.

- unfortunately, capsules are not recommended to be broken and used as a powder. The reason for this is that drugs that are in capsules are not to be in contact with the stomach mucosa as in some cases the acids in the stomach may destroy the drug and not allow it to work an effect. In some cases, if the drug is in contact with the stomach mucosa while it would not be, it may cause damage to the stomach mucosa. For these reasons, it is not recommended to open the capsules.

I hope I have answered your query and have been helpful to you. Let me know if I can assist you further.

Regards,
Dr. Antoneta Zotaj
General and Family Physician

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