American Board of Internal Medicine (ABIM) Certification Practice Exam

For disseminated gonococcal infection, what is the regimen for treatment?

1. Ceftriaxone, 1 g IM or IV every 48 hours

2. Ceftriaxone, 1 g IM or IV every 24 hours

3. Ampicillin, 1 g IV every 8 hours

4. Vancomycin, 2 g IV every 12 hours

The correct answer is: Ceftriaxone, 1 g IM or IV every 24 hours

The recommended treatment regimen for disseminated gonococcal infection includes ceftriaxone administered at a dose of 1 g either intramuscularly (IM) or intravenously (IV) every 24 hours. This approach effectively targets the Neisseria gonorrhoeae organism, which is responsible for the infection. Ceftriaxone is a broad-spectrum cephalosporin antibiotic that is particularly effective against gram-negative bacteria, including the strains of Neisseria gonorrhoeae that may cause disseminated infections. The 24-hour dosing schedule is optimal for maintaining adequate drug levels in the bloodstream, ensuring effective and sustained antibacterial activity throughout the treatment period. This regimen typically lasts for a duration of 7 days, though the exact length can vary based on clinical response and severity of infection. In contrast, a dosing regimen of ceftriaxone every 48 hours would likely lead to suboptimal therapeutic levels, risking treatment failure. Other antibiotics listed, such as ampicillin and vancomycin, are not the first-line treatments for disseminated gonococcal infection, as they do not adequately target the specific bacteria responsible for this condition. Therefore, selecting ceftriaxone at the correct dose and frequency is critical for