A 23-Year-Old Man Comes to the Office Due to Several

A 23-year-old man comes to the office due to several days of dysuria.  He has had no fever or hematuria.  The patient has no other medical conditions, takes no medications, and has no known allergies.  Temperature is 37.1 C (98.8 F) .  On genitourinary examination, mucopurulent discharge is noted at the urethral meatus.  Microscopy of the discharge shows numerous neutrophils, some of which contain intracellular gram-negative diplococci.  A single intramuscular injection of ceftriaxone is administered.  Which of the following additional medications is recommended at this time?

A) Doxycycline
B) Fluconazole
C) Metronidazole
D) No additional medication
E) Penicillin G benzathine
F) Trimethoprim-sulfamethoxazole

Correct Answer:

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