Obstetrics & Gynecology>>>>>Medical and Surgical Complications of Pregnancy
Question 3#

A 19-year-old P0 presents for her first OB visit at 10 weeks’ gestation. You order routine OB laboratory tests, and it returns showing a positive nucleic acid probe for Neisseria gonorrhoeae. One year ago, she was treated with ampicillin for a simple urinary tract infection and developed a severe allergic reaction.

Which of the following is the best option for treatment at this time?

a. Tetracycline
b. Doxycycline
c. Azithromycin
d. Ceftriaxone
e. Penicillin

Correct Answer is C

Comment:

Patients with a severe allergic reaction to ampicillin should not receive penicillin. Patient with this type of reaction have up to a 20% incidence of reaction to cephalosporins, so ceftriaxone should be avoided as well unless desensitization is undertaken. Spectinomycin used to be the treatment of choice for pregnant women with Neisseria gonorrhoeae infections and who were allergic to penicillin; however, the production of this medication was discontinued in the United States in 2006. The use of doxycycline or tetracycline is generally contraindicated in pregnancy. Azithromycin 2 g orally as a single dose may be used as an alternative to treat both gonorrhea and chlamydia.