MMWR in latest Grand round section discussed the options for gonorrhea treatment and their recommendation in case of cephalosporin allergy,
From CDC Site:
Treatment for Gonorrhea at any anatomic site : a single 250 mg intramuscular dose of ceftriaxone + either 1 g of azithromycin as a single oral dose or 100 mg of doxycycline orally twice daily for 7 days. If this recommended regimen cannot be used, two alternative treatment options exist for urogenital or rectal gonorrhea:
1) if ceftriaxone is not available, clinicians can consider cefixime 400 mg as a single oral dose and either azithromycin 1 g as a single oral dose or doxycycline 100 mg orally twice daily for 7 days, or
2) if the patient is cephalosporin-allergic, clinicians can consider azithromycin 2 g as a single oral dose. If either of these two alternative regimens is prescribed, the patient should return in 1 week for a test of cure.