A neonate born vaginally to a mother with untreated N. gonorrhea should receive

A neonate born vaginally to a mother with untreated N. gonorrhea should receive

• A. Ceftriaxone
• B. Penicillin
• C. Erythromycin
• D. Azithromycin

Answer: (A)

When a newborn is exposed to an untreated maternal Neisseria gonorrhoeae infection, there is a real risk of gonorrheal infection that can involve the eyes and potentially progress systemically. Treating the neonate with a systemic antibiotic active against N. gonorrhoeae is necessary, not just eye prophylaxis. Ceftriaxone is the drug of choice because it reliably covers Neisseria gonorrhoeae and achieves adequate concentrations in the blood and ocular tissues to prevent and treat ophthalmia neonatorum and potential disseminated disease. Penicillin is increasingly ineffective due to resistance, and erythromycin or azithromycin do not reliably treat gonorrhea (they’re more aligned with co-infection management, such as for chlamydia, and are not adequate mono-therapy for gonorrhea). So the best approach is systemic ceftriaxone for a newborn with this exposure.

When a newborn is exposed to an untreated maternal Neisseria gonorrhoeae infection, there is a real risk of gonorrheal infection that can involve the eyes and potentially progress systemically. Treating the neonate with a systemic antibiotic active against N. gonorrhoeae is necessary, not just eye prophylaxis. Ceftriaxone is the drug of choice because it reliably covers Neisseria gonorrhoeae and achieves adequate concentrations in the blood and ocular tissues to prevent and treat ophthalmia neonatorum and potential disseminated disease. Penicillin is increasingly ineffective due to resistance, and erythromycin or azithromycin do not reliably treat gonorrhea (they’re more aligned with co-infection management, such as for chlamydia, and are not adequate mono-therapy for gonorrhea). So the best approach is systemic ceftriaxone for a newborn with this exposure.