A 21-year-old cisgender man has a return visit to the sexual health clinic with urethral discomfort and purulent discharge.
A 21-year-old cisgender man has a return visit to the sexual health clinic with urethral discomfort and purulent discharge. Six days prior, he was diagnosed with urethral gonorrhea and received appropriate treatment. He states his symptoms have not improved, and he denies sexual contact with anyone since receiving treatment for gonorrhea. A diagnosis of antimicrobial-resistant Neisseria gonorrhoeae infection is suspected and a urethral swab for culture is obtained. Which one of the following is the best choice for treating gonorrhea if there is a high suspicion for cephalosporin-resistant Neisseria gonorrhoeae? Azithromycin 2 g orally as a single dose Oral moxifloxacin 400 mg once daily for 3 days plus oral doxycycline 100 mg twice daily for 7 days Gentamicin 240 mg as a single intramuscular dose plus azithromycin 2 g as a single oral dose Oral clindamycin 600 mg three times daily for 7 days plus oral atovaquone 750 mg twice daily for 7 days
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