The CDC has issued new recommendations for treatment of gonococcal infection. A single 500-mg IM dose (1000 mg in patients weighing ≥150 kg) of the third-generation cephalosporin ceftriaxone is now the treatment of choice for patients with uncomplicated urogenital, rectal, or pharyngeal gonorrhea.

The FDA has approved two antibiotics, gepotidacin (Blujepa — GSK) and zoliflodacin (Nuzolvence — Entasis), for oral treatment of uncomplicated urogenital gonorrhea in patients ≥12 years old. Gepotidacin is approved for use in persons weighing ≥45 kg who have limited or no alternative treatment options; it was approved in 2025 for treatment of uncomplicated urinary tract infection in females. Zoliflodacin is approved for use in persons weighing ≥35 kg. Neither drug is indicated for treatment of rectal or pharyngeal gonorrhea.

This article includes recommendations for management of most sexually transmitted infections (STIs) other than HIV and viral hepatitis. Some of the indications and dosages recommended here have not been approved by the FDA (see Table 1).

Most respiratory tract infections are caused by viruses. Bacterial respiratory tract infections are usually treated empirically with antibiotic therapy that targets the most probable causative pathogens. Recommended antibiotic regimens for outpatient treatment of some common respiratory tract infections are listed in Table 1 for adults and Table 2 for children.

On July 10, 2025 Pfizer issued a voluntary recall of certain lots of long-acting intramuscular (IM) benzathine penicillin G (Bicillin L-A) due to particulates identified during visual inspection. The CDC has issued a "Dear Colleague Letter" to alert healthcare providers about the recall and provide advice on how to manage the potentially limited supply of the drug for treatment of syphilis, which has been increasing in the US.2 Benzathine penicillin G is also used for treatment of group A streptococcal pharyngitis and prophylaxis of rheumatic fever.

The main goals of treatment of chronic obstructive pulmonary disease (COPD) are to relieve symptoms, reduce the frequency and severity of exacerbations, prevent disease progression, and reduce mortality. GOLD (Global Initiative for Chronic Obstructive Lung Disease) guidelines for treatment of COPD were updated recently. Treatment of acute exacerbations is not discussed here. Drugs available for treatment of COPD are listed in Tables 1 and 3.

Since 2007, antimicrobial prophylaxis for dental procedures has been recommended to prevent viridans group streptococcal infective endocarditis only for patients at highest risk of an adverse outcome. Limiting use to such patients does not appear to have led to an increased incidence of infective endocarditis or increased mortality due to infective endocarditis.

The FDA has approved the subcutaneously injected interleukin (IL)-4 receptor alpha antagonist dupilumab (Dupixent – Sanofi/Regeneron) for add-on maintenance treatment of adults with inadequately controlled chronic obstructive pulmonary disease (COPD) and an eosinophilic phenotype. Dupilumab is the first biologic drug to be approved in the US for this indication. It has been available for years for treatment of asthma, atopic dermatitis, chronic rhinosinusitis with nasal polyps, eosinophilic esophagitis, and prurigo nodularis.

More antibiotics are prescribed for treatment of acute otitis media (AOM) than for any other infection in young children. Children with AOM typically present with otalgia, fever, and bulging and erythema of the tympanic membrane.

The goal of asthma treatment is to control symptoms, prevent exacerbations, and maintain normal lung function. Management of acute exacerbations in the emergency department is not discussed here.