Region of Peel logo

Search

Region of Peel logo

Health Professionals Update - Vol. 18, No. 4

February 3, 2025

From: 
Monica Hau, MD, MSc, CCFP, FRCPC 
Associate Medical Officer of Health

In this issue:

  • Update: Revised guidelines for gonorrhea infection treatment and testing
  • New: Malton Sexual Health clinic reopening and extended clinic hours
  • Reminder: STI medication and condom distribution program
  • Reminder: GetaKit STBBI testing program

Key messages:

  • The recommended treatment for uncomplicated gonorrhea infections is now ceftriaxone 500 mg IM in a single dose.
  • The Malton sexual health clinic has reopened, and walk-in and extended hours are now available at all four sites.
  • Free STI medications and condoms are available to bulk order.
  • GetaKit offers free, at-home and lab-based self-testing for sexually transmitted and blood borne infections (STBBIs) for Peel residents.

Update: Revised guidelines for gonorrhea infection treatment and testing

Treatment recommendations

The Public Health Agency of Canada (PHAC) has revised the guidelines for the treatment of gonorrhea infection in the context of changing patterns of resistance to azithromycin and cefixime. The preferred treatment recommendation for uncomplicated gonorrhea infection (i.e., urethral, endocervical, vaginal, rectal and pharyngeal infections)* is ceftriaxone 500 mg IM as a single dose (monotherapy). Ceftriaxone vials will continue to come in 250 mg per vial and therefore two vials are needed to treat a patient infected with gonorrhea. 

This replaces the previous preference for combination therapy (e.g. ceftriaxone 250 mg IM + azithromycin 1 g PO).  Health care providers should no longer follow the 2018 Ontario Gonorrhea Testing and Treatment Guide. For more information on this change as well as alternative treatment regimens, please refer to the Canadian Guidelines for Sexually Transmitted Infections or Gonorrhea guide: Key information and resources. 

*For non-pregnant/lactating patients for whom chlamydia infection has not been ruled out with a negative test, concurrent treatment for chlamydia with azithromycin 1g po in a single dose OR doxycycline 100mg po BID for 7 days should also be offered as per PHAC’s Chlamydia and LGV Guidance.

Testing recommendations

Culture is recommended where feasible (to assess drug sensitivity) in addition to the specimens for nucleic amplification testing (NAAT), especially in cases of:

  • suspected treatment failure
  • infections acquired in areas with high rates of antimicrobial resistance
  • symptomatic patients
  • pelvic inflammatory disease (PID)
  • pregnancy
  • sexual abuse/sexual assault, or
  • asymptomatic individual notified as a contact of a gonorrhea cases

Test of Cure Recommendations

Patients should abstain from any sexual activity until treatment of the person and all current partners is complete (seven days following single dose therapy) and symptoms have resolved. 

A Test of Cure is recommended for all positive sites in all cases:

  • 3 to 21 days after treatment completion, regardless of patient's symptom status: culture is recommended.
  • After 21 days from treatment completion and patient is:
    • Asymptomatic - NAAT is recommended
    • Symptomatic - both culture and NAAT are recommended

New: Malton Sexual Health clinic reopening and extended clinic hours

Peel Public Health has expanded its sexual health services with the re-opening of the Malton Clinic in the Westwood Square Mall (7205 Goreway Drive, Lower Level, Mississauga) on Wednesdays from 1:30 – 6:30 pm.  All four clinic locations are now offering extended walk-in hours on various evenings throughout the week.      

Please continue to visit our website for up-to-date locations, hours, services and eligibility.

Reminder: STI medication and condom distribution program

Health care providers in Peel Region can bulk order free medications to treat chlamydia, gonorrhea, and syphilis through the STI Medication Distribution Program. Boxes of free condoms are also available. 
NOTE: Bulk Bicillin ordering (for syphilis treatment) is available to Health Care Professionals who frequently diagnose and treat syphilis in their practices.
If you are interested in learning more about our program, visit: Communicable diseases - peelregion.ca.

Reminder: GetaKit STBBI testing program

GetaKit (GAK) offers no-cost at-home HIV self-tests and no appointment, lab-based testing for STIs including HIV, syphilis, hepatitis C, gonorrhea, and chlamydia.

GAK is now available to eligible Peel residents with health insurance (e.g. OHIP, IFH, UHIP, private insurance). Tests can be ordered online from anywhere, 24/7.

Requisitions for testing are sent through the mail or made available online and tests are completed at a local lab. Test kits include self-collected rectal and pharyngeal swabs.

For more information on this service and eligibility, visit GetaKit.ca.  

Contact us

The Health Professionals Update (HPU) is distributed to physician offices in Peel region via fax or email. Share this update with other health professionals in your clinic. 

More information: