For gonorrhea and chlamydia coinfection, which regimen is recommended?

• A. Ceftriaxone IM single dose + Azithromycin 1 gram PO single dose
• B. Ceftriaxone IM single dose
• C. Azithromycin 1 gram PO single dose
• D. Doxycycline 100 mg PO bid for 7 days

Answer: (A)

Treating a patient with gonorrhea and chlamydia coinfection requires covering both organisms at once. Ceftriaxone given as an intramuscular dose provides strong, reliable therapy against gonorrhea, while a single-dose azithromycin taken orally adds coverage for chlamydia and has the advantage of ensuring adherence with a one-time dose. Because many patients with gonorrhea also have chlamydia, this combination reduces the risk of leaving a coinfecting organism untreated and helps prevent ongoing transmission and complications.

Opting for ceftriaxone alone would leave chlamydia untreated, and azithromycin alone would leave gonorrhea untreated. Doxycycline alone isn’t sufficient for gonorrhea and isn’t the recommended approach for coinfection in current practice, since guidelines emphasize incorporating a gonorrhea-active agent alongside therapy for chlamydia.