Gonococcal conjunctivitis treatment includes which of the following?

• A. Refer to PCP for IM Ceftriaxone 1 g, Azithromycin 1 g PO single dose, and Moxifloxacin 0.5% q2h
• B. Topical steroids only
• C. Oral doxycycline alone
• D. Observation without treatment

Answer: (A)

Gonococcal conjunctivitis requires systemic antibiotics because Neisseria gonorrhoeae can quickly cause a severe, purulent infection of the eye and risk corneal involvement. The best approach is to treat systemically with an intramuscular dose of ceftriaxone 1 g to eradicate the organism from the eye and prevent spread. Because many patients with gonorrhea are coinfected with Chlamydia trachomatis, adding a single-dose oral azithromycin 1 g helps cover that possibility. A topical antibiotic, such as moxifloxacin eye drops administered regularly, is useful as an adjunct to reduce local bacterial load, but it does not replace systemic therapy.

The other options fall short because topical steroids can suppress inflammation but worsen an active, potentially blinding infection; doxycycline alone does not reliably treat gonococcus; and watching without treatment allows the infection to progress and cause serious complications.