In disseminated gonococcal infection with Chlamydia co-infection, which regimen is recommended?

• A. No treatment for chlamydia
• B. IV penicillin alone
• C. IV ceftriaxone plus doxycycline
• D. Oral azithromycin alone

Answer: (C)

Disseminated gonococcal infection needs potent initial therapy that covers Neisseria gonorrhoeae in the blood and joints, plus treatment for possible concurrent Chlamydia trachomatis infection. Ceftriaxone given intravenously is the drug of choice because it achieves reliable, high levels in blood and tissues and is effective against gonorrhea, including strains resistant to penicillins and older antibiotics. Because Chlamydia co-infection is common in gonorrhea, adding doxycycline provides active coverage for Chlamydia for about a week, reducing the risk of persistent infection or complications. This combination is preferred over regimens that would miss gonorrhea treatment or rely on less effective or monotherapy strategies.