Skip to main content
Drug Info

Does metronidazole treat gonorrhea?

Metronidazole does not treat gonorrhea but may be used to treat other STIs
Karen Berger medical writer and reviewer headshot
By | Dec. 10, 2024
Spilled Rx bottle: Does metronidazole treat gonorrhea?
In this article:

Metronidazole is a prescription medication commonly used for various types of bacterial and protozoal infections. Commonly referred to by the brand name Flagyl, metronidazole is available in various formulations, including oral tablets and capsules, as well as topical and vaginal forms. Metronidazole is part of a drug class called nitroimidazole antimicrobials. Because it has so many uses, people often ask, Does metronidazole treat gonorrhea? While metronidazole does not treat gonorrhea, it is FDA-approved to treat many types of infections, such as trichomoniasis, pelvic inflammatory disease, bacterial vaginosis, skin infections, central nervous system infections, bone and joint infections, and many others. 

Can metronidazole be used to treat gonorrhea or chlamydia?

Metronidazole does not treat gonorrhea or chlamydia. It is not effective against the types of bacteria that cause these infections. 

  • Gonorrhea is a sexually transmitted infection (STI) caused by a type of bacteria called Neisseria gonorrhoeae (N. gonorrhoeae). Gonorrhea is very common, especially among adolescents and young adults 15 to 24 years of age. It can be spread by vaginal, anal, or oral sex without a condom. It can also be transferred to a newborn during childbirth by an infected pregnant individual. Gonorrhea can cause infection in the genitals, rectum, or throat. It is usually treated with a single injection of an antibiotic medicine called ceftriaxone (a cephalosporin antibiotic).
  • Chlamydia is an STI caused by a type of bacteria called Chlamydia trachomatis. It can be spread in the same ways as gonorrhea. Chlamydia is usually treated with an oral antibiotic called doxycycline (a tetracycline antibiotic).

What STD does metronidazole treat?

Trichomoniasis

Trichomoniasis is a common STI caused by a protozoan parasite known as Trichomonas vaginalis. Many people with this condition do not have symptoms. Metronidazole is used to treat trichomoniasis in males and females. Pregnant women should not use it in the first trimester. For trichomoniasis, both partners should consult a healthcare provider for a diagnosis and treatment plan. There are several ways to treat trichomoniasis with metronidazole, including:

  • 2 grams (or 2,000 mg), which can be taken all at once as a single dose or divided into two doses of 1,000 mg each, taken on the same day
  • 250 mg three times a day for seven days
  • 375 or 500 mg twice daily for seven days

The healthcare provider will determine which treatment regimen is appropriate. Some people may need another course of treatment. 

Pelvic inflammatory disease (PID)

Metronidazole can also be used to treat pelvic inflammatory disease (PID). PID is an infection of a woman’s reproductive organs. It can be caused by certain sexually transmitted diseases, including chlamydia and gonorrhea. It can also be caused by infections that are not sexually transmitted. It’s important to note that metronidazole does not directly treat chlamydia or gonorrhea, but it can be used to treat PID, which may occur as a complication of one of these infections. For PID, metronidazole is generally prescribed at a dose of 500 mg twice daily, in combination with other medication as determined by the healthcare provider, depending on the presence of other infections.

Bacterial vaginosis (BV)

Bacterial vaginosis (BV) is a common vaginal infection. While it is not classified as an STI itself (and experts do not fully understand how sex and BV are related), people who do not use condoms, as well as those with multiple partners, have a higher risk of getting BV. BV infections can also increase the risk of getting other STIs. For BV, metronidazole can be prescribed to be taken by mouth, usually at a dose of 500 mg twice daily for seven days. Or, a vaginal form of metronidazole gel can be used. With this formulation, the patient inserts one applicatorful of medicine vaginally once a day (usually at bedtime) for five days. 

Gonorrhea symptoms

According to the CDC, symptoms of gonorrhea may vary. People with gonorrhea may have no symptoms or mild symptoms. Women may experience burning or pain while peeing, vaginal discharge, and bleeding or spotting between periods. Men may experience burning while peeing, discharge from the penis, and, less commonly, pain or swelling in the testicles. People with rectal infections who experience symptoms may have anal discharge, itching, soreness, bleeding, or painful bowel movements. 

Both you and your partner(s) need to get treated for gonorrhea. Untreated gonorrhea can spread and lead to various complications, such as PID in women, which can lead to infertility. Untreated gonorrhea can also lead to infertility in men, as well as other problems. 

The Centers for Disease Control and Prevention (CDC) recommends a one-time intramuscular injection (injection into a muscle) of the antibiotic ceftriaxone to treat gonorrhea. 

If this treatment is not available, the CDC recommends one dose of an oral antibiotic called cefixime. Expedited Partner Therapy (EPT) is also recommended, allowing partners of a patient diagnosed with an STI to receive treatment without a medical evaluation. For gonorrhea, the EPT is usually one dose of cefixime. If chlamydia cannot be ruled out, the healthcare provider will likely also prescribe a seven-day course of doxycycline to both the patient and their partner. 

How quickly does gonorrhea clear up?

After antibiotic treatment, it generally takes about 7 to 14 days for a gonorrhea infection to clear up, although some people may have symptoms for longer. Your healthcare provider will advise you how long you should avoid having sex (generally, for at least seven days) after treatment to avoid spreading the infection. Your healthcare provider may recommend additional testing to make sure the infection is clear, so be sure to follow their instructions for treatment and keep all follow-up appointments. They may also recommend a regular testing schedule, especially for people at higher risk, as part of an ongoing care plan. A regular testing schedule can allow for testing of gonorrhea as well as other sexually transmitted diseases such as herpes, HIV infection, and syphilis. 

While the only surefire way to avoid an STI is abstinence, you can significantly reduce your risk of contracting gonorrhea by using condoms correctly every time you have sex and by being in a long-term relationship where both partners are monogamous and have tested negative for gonorrhea.

The bottom line

Metronidazole is used for a variety of infections. Although it is not effective against gonorrhea, metronidazole is commonly used to treat trichomoniasis, pelvic inflammatory disease (PID), and bacterial vaginosis. Regardless of the type of sexually transmitted infection you have, it is important to keep all follow-up appointments to ensure the infection goes away. It is also important to follow other recommendations from your healthcare provider in terms of avoiding sexual activity while you are infected, using condoms, and regular testing.

Sources