Question 87

Question:

A young male was recently diagnosed with a sexually transmitted infection in which kidney-shaped, Gram-negative diplococci were found in cytoplasmic inclusions of neutrophils. The young male is allergic to penicillin. Administration of which of the following drug(s) is most appropriate?

Correct Answer: B.  Azithromycin & Doxycycline

The patient has Neisseria gonorrhoeae. The current therapy of choice is ceftriaxone, but because of his allergy to penicillin, doxycycline (x7 days) is the best alternative treatment. However, the patient should also be treated with azithromycin for Chlamydia trachomatis because up to 50% of patients will be concurrently infected.
Fluoroquinolones were frequently used for N. gonorrhea treatment until recently. In April 2007, the CDC discontinued the fluoroquinolone recommendation due to increased resistance among the population.