A 27-year-old woman comes to the Sexually Transmitted Diseases


#1

A 27-year-old woman comes to the Sexually Transmitted D iseases Clime complaining of pain on passing urine, a urethral discharge and discomfort on sexual intercourse. She has previously attended the clinic with an episode of gonorrhoea, and she has just left her partner after he admitted to intercourse outside the relationship. You conform pelvic tenderness on examination, and discharge.
Investigations;
Positive NAAT for gonorrhoea HIV: negative Chlamydia: negative
Which of the following is the most appropriate intervention?

A Amoxicillin
Ceftriaxone and azithromycin
c Ciprofloxacin
D Doxycycline
E Erythromycin and metronidazole

explanation:
The fact this patient has been infected for the second time with gonorrhoea, does not change the accepted intervention, a single dose of ceftriaxone IM, and oral azithromycin.
Amoxicillin, (Option A), is incorrect. Penicillins are not recommended for the treatment of gonorrhoea because of Increasing resistance to penicillins.
Ciprofloxacin, (Option C), is incorrect. There IS widespread resistance of gonorrhoea to quinolones, as such they are no longer recommended as first line intervention in the UK for gonorrhoea.
Doxycycline, (Option D). is incorrect. Doxycycline is recommended for the treatment of chlamydia infection, not for gonorrhoea because of resistance.
Erythromycin and metronidazole, (Option E), is incorrect. Twice daily erythromycin and metronidazole for 14 days is a recommended intervention for pelvic inflammatory disease.