Which antibiotic regimen is appropriate for gonorrhea co-infection with chlamydia?

• A. Azithromycin monotherapy
• B. Penicillin V
• C. Ceftriaxone plus doxycycline
• D. Clindamycin

Answer: (C)

When a gonorrhea infection may be accompanied by chlamydia, the best approach is to use dual therapy that covers both pathogens in one regimen and helps address resistance.

Ceftriaxone provides robust activity against Neisseria gonorrhoeae, including strains that have become harder to treat. Adding doxycycline targets Chlamydia trachomatis, which commonly coexists with gonorrhea. This combination is the standard approach when co-infection is suspected or not ruled out, ensuring both infections are treated effectively.

Azithromycin monotherapy isn’t adequate because gonorrhea resistance makes single-drug therapy unreliable for clearing the infection, and it doesn’t guarantee chlamydia coverage in a co-infected patient. Penicillin V is ineffective against gonorrhea due to resistance, and clindamycin does not reliably treat gonorrhea either.