গনোরিয়ার চিকিৎসা: আসলে কীসে এটি সেরে যায় এবং এরপর কী হয়

শেষ আপডেট: আগস্ট 22, 2026

• ওয়ার্ডপ্রেস
• লিঙ্কডইন
• মেইল

Gonorrhoea is curable. That is the good news, and it has stayed true even as the bacterium has spent decades defeating one antibiotic after another. What has changed is how it is cured — and the gap between current treatment and what most people assume, or can buy over a pharmacy counter, is now wide enough to matter.

A note on what this article is. It describes how gonorrhoea is treated so that you understand what is happening to you and what you must do afterwards. It deliberately does not print antibiotic names with doses, because gonorrhoea is not a condition to self-treat: the choice of drug depends on where in the body the infection is, on what else you may have caught at the same time, and on local resistance patterns — and getting it wrong leaves you infectious and helps breed a more resistant organism. This article was originally written around the CDC’s 2020 update; that update was subsequently folded into the CDC’s consolidated 2021 sexually transmitted infections treatment guidelines, which is the reference in use.

• ইউরোলজি সেন্টার ব্যাংকক হাসপাতাল থাইল্যান্ড অনলাইনে বুক করুন 02-310-3009 bhquro@bdms.co.th
• সামিটেজ শ্রীরাচা হাসপাতাল চোনবুড়ি 088-022-1445

Why It Is an Injection, Not a Tablet

Gonorrhoea has, in turn, become resistant to penicillins, to tetracyclines and to the quinolone antibiotics — the class that includes the tablets many men in Thailand still take for a urinary infection. Those no longer reliably cure it. For a time the answer was dual therapy, an injection plus an oral antibiotic together; that has since been simplified back to a single injection of a cephalosporin antibiotic (ceftriaxone), given at a higher dose than before, with the second drug added only when chlamydia has not been ruled out.

The practical consequence for a patient: an oral antibiotic bought over the counter is not treatment for gonorrhoea. It may quieten the discharge for a few days, which is worse than useless — you feel better, you stop attending, the infection persists, you remain infectious, and the organism gets another round of practice against the drug. Alternatives to the injection do exist for men who cannot receive it, but they are second choices selected by a doctor, not substitutes a patient picks.

Chlamydia Travels With It

Gonorrhoea and chlamydia are found together often enough that if chlamydia has not been excluded by testing, a course of oral antibiotic is given alongside the injection. Chlamydia is the quieter of the two — frequently symptomless, particularly in women — and it is the one that causes pelvic inflammatory disease and tubal infertility if it is left. This is one reason testing beats guessing: a urine PCR panel can identify several organisms at once from a single sample, without a swab.

The Part That Is Not About Drugs

Treatment fails most often not because the antibiotic was wrong but because of what happened after it. Four things matter as much as the injection:

• Your partner or partners must be tested and treated, even if they have no symptoms at all — which is usual, especially in women. If they are not, you will be reinfected, and the cycle simply restarts. Recent partners, going back some weeks, need telling; it is an unpleasant conversation and it is the single most useful thing you can do.
• No sex — including oral sex — until seven days after treatment, and not until your partners have completed theirs.
• Get retested a few months later. Reinfection is common, and it usually reflects an untreated partner rather than treatment failure. Where the infection was in the throat, a test to confirm cure is also advised, because throat infection is harder to clear and rarely causes symptoms to warn you.
• Get screened for the others. Anyone diagnosed with one sexually transmitted infection should be checked for the rest, syphilis and HIV included. Note that HIV testing, and pre- and post-exposure prophylaxis, are handled by the Infectious Diseases department at Bangkok Hospital Headquarters rather than in the urology clinic — and PEP is time-critical, so a man who may need it after a high-risk exposure should go directly to an Infectious Diseases service or an emergency department rather than wait for a routine appointment.

When Gonorrhoea Becomes an Emergency

Untreated gonorrhoea occasionally spreads into the bloodstream. Go to an emergency department, or call 1669 in Thailand, if you develop:

• Fever with painful, swollen joints — particularly a single hot swollen knee, wrist or ankle
• A scattered rash of small spots or pustules, often on the limbs, together with fever
• Pain and tendon swelling around the wrists, ankles or fingers
• A painful, swollen testicle, or fever with lower abdominal or pelvic pain in a woman
• Eye redness with discharge after possible contact — gonococcal eye infection can threaten sight and needs same-day care

Symptoms that simply are not settling several days after treatment also need review rather than a second guess at an antibiotic. Where a true treatment failure is suspected, a culture is taken so the organism can be tested against individual antibiotics — the PCR test that diagnoses the infection cannot tell you what it is resistant to.

For what gonorrhoea feels like and how it is diagnosed, see this companion article, or the STI testing and treatment service page.

প্রায়শই জিজ্ঞাসিত প্রশ্ন

How is gonorrhoea treated today?

For an uncomplicated infection, with a single intramuscular injection of a cephalosporin antibiotic (ceftriaxone), given at a higher dose than was used in the past. A course of oral antibiotic is added when chlamydia co-infection has not been excluded. The dose depends on the patient and is set by the treating doctor, so it is not printed here. Alternatives exist for people who cannot have the injection, but they are second choices selected clinically.

Can I just buy antibiotics for gonorrhoea at a pharmacy?

No — and this is the most common way the infection persists. Gonorrhoea is now resistant to several classes of oral antibiotic, including the quinolones that are widely sold. An oral antibiotic may reduce the discharge for a few days without curing anything: you feel better, stop attending, remain infectious, and the organism gains further resistance. Untreated infection can also spread to the joints and bloodstream.

Does my partner need treatment if they have no symptoms?

Yes. Absence of symptoms is the usual situation, particularly in women, and an untreated partner is the commonest reason a cured man is reinfected within weeks. Recent partners going back some weeks should be told, tested and treated. Avoid sex, including oral sex, until seven days after your treatment and until your partners have completed theirs.

Do I need a test to confirm the infection has gone?

For a straightforward genital infection that responds, a test of cure is not routinely required, but retesting a few months later is advised because reinfection is common. Throat infection is different: it is harder to clear and rarely produces symptoms, so confirming cure is recommended there. Symptoms that persist after treatment should be reviewed rather than treated with another guess.

What if the treatment does not work?

True treatment failure is uncommon, and reinfection from an untreated partner is far more likely. Where genuine failure is suspected, a culture is taken so the strain can be tested against individual antibiotics — the PCR test used for diagnosis identifies the organism but cannot show what it resists. Treatment is then chosen from that result.

When is gonorrhoea an emergency?

Go to an emergency department, or call 1669 in Thailand, for fever with painful swollen joints, a scattered rash of small spots with fever, tendon pain and swelling around wrists or ankles, a painful swollen testicle, fever with pelvic pain in a woman, or eye redness with discharge after possible contact. These suggest the infection has spread beyond the genital tract.

অ্যাপয়েন্টমেন্ট বুক করুন

Dr. Soarawee Weerasopone provides confidential testing and treatment for sexually transmitted infections at ব্যাংকক হসপিটাল সদর দপ্তর and at Samitivej Sriracha Hospital, Chonburi — Urology department 088-022-1445. HIV testing and PrEP or PEP are handled by the Infectious Diseases department rather than the urology clinic. Questions about cost are answered by the hospital rather than by Dr. Soarawee — for Bangkok Hospital, by email to bhquro@bdms.co.th.

ব্যাংকক হসপিটাল টেলিমেডিসিন এমন রোগীদের জন্য উপলব্ধ যারা সশরীরে উপস্থিত হতে পারেন না, যার মধ্যে আন্তর্জাতিক রোগীরাও অন্তর্ভুক্ত — ইউরোলজি বিভাগে ইমেলের মাধ্যমে এটি অগ্রিম ব্যবস্থা করুন bhquro@bdms.co.th. Testing and the treatment injection require an in-person visit. Samitivej Sriracha is in-person only.

দাবি পরিত্যাগ This article is written and reviewed by Dr. Soarawee Weerasopone, a board-certified urologist at Bangkok Hospital Headquarters. It is educational only, is not medical advice, and does not create a doctor–patient relationship. It gives no antibiotic doses: gonorrhoea must not be self-treated, and treatment is prescribed after testing. Recommended regimens change as resistance changes, and local guidance may differ from the international guidance described here. No diagnosis, prescription or individual medical advice is given through personal messaging channels or social media, and Dr. Soarawee operates no public social media account — any account offering private consultation in his name is fraudulent. If you have fever with joint pain or a rash, a painful swollen testicle, or any other urgent symptom, go to an emergency department or call 1669 in Thailand.