In the treatment of uncomplicated Neisseria gonorrhoeae infection in nonpregnant patients, which regimen is recommended to cover Chlamydia coinfection?

• A. Ceftriaxone plus azithromycin
• B. Ceftriaxone
• C. Ceftriaxone plus doxycycline
• D. Doxycycline

Answer: (C)

Coinfection with Chlamydia trachomatis is common in patients with gonorrhea, so treatment aims to cover both pathogens. Ceftriaxone is the drug of choice for uncomplicated gonorrhea because it effectively treats Neisseria gonorrhoeae and counters resistance concerns. But to address potential concurrent Chlamydia infection, adding a regimen that covers Chlamydia is important. Doxycycline provides reliable Chlamydia coverage, so combining ceftriaxone with doxycycline ensures treatment of both infections in one course. Doxycycline alone wouldn’t treat gonorrhea, and ceftriaxone alone wouldn’t address Chlamydia coinfection. An alternative like ceftriaxone plus azithromycin exists for cases where doxycycline can’t be used, but the preferred approach in nonpregnant patients to cover both organisms is ceftriaxone plus doxycycline.