What is the first-line treatment for proctitis caused by Neisseria gonorrhoeae?

For proctitis caused by Neisseria gonorrhoeae, the first-line treatment is ceftriaxone. This antibiotic is a third-generation cephalosporin that is effective against the bacteria causing gonorrhea, including strains that may be resistant to other medications. The recommended dosage for treating gonococcal infections typically involves a single intramuscular injection of ceftriaxone, which ensures rapid and effective clearance of the infection.

In cases of proctitis, which can occur in men who have sex with men or in other high-risk populations, targeting Neisseria gonorrhoeae is crucial as it is a common etiological agent. Since gonorrhea frequently coexists with chlamydial infections, dual therapy with azithromycin is often recommended to cover both organisms; however, ceftriaxone is specifically prioritized for treating the gonococcal infection itself.

Other antibiotics listed are not first-line recommendations for proctitis associated with Neisseria gonorrhoeae. Doxycycline is more often used for chlamydia and other specific infections; metronidazole is mainly effective against anaerobes and protozoa, not for Neisseria gonorrhoeae; azithromycin is typically used