What drug is the first-line treatment for gonorrhea?

Ceftriaxone is the first-line treatment for gonorrhea due to its effectiveness against Neisseria gonorrhoeae, the bacterium responsible for the infection. This cephalosporin antibiotic has excellent penetrative ability and is effective in treating various bacterial infections, including those resistant to other antibiotics.

The current guidelines recommend ceftriaxone administered intramuscularly, often in combination with azithromycin to cover potential co-infection with Chlamydia trachomatis, though azithromycin alone is not effective for gonorrhea treatment due to increasing resistance.

Other drugs listed, such as nitrofurantoin, azithromycin, and doxycycline, are used for different indications or infections. Nitrofurantoin is primarily used for urinary tract infections. Azithromycin is effective for some bacterial infections and is used in combination with ceftriaxone for gonorrhea but is not a standalone first-line treatment. Doxycycline is primarily used for other infections such as chlamydia but does not have the same first-line status for gonorrhea as ceftriaxone.