Which antibiotic is indicated for gonorrheal conjunctivitis and orbital cellulitis?

• A. Tobra/Gentamicin
• B. Amoxicillin
• C. Ceftriaxone
• D. Doxycycline

Answer: (C)

Gonococcal conjunctivitis requires systemic therapy because Neisseria gonorrhoeae can cause a rapidly progressive infection and may be present in other sites as well; you need an antibiotic that reliably reaches ocular tissues and has strong activity against gonorrhea. Ceftriaxone, a third-generation cephalosporin, fits this need with excellent activity against N. gonorrhoeae and good ocular and soft-tissue penetration, making it effective for both gonococcal conjunctivitis and orbital cellulitis, which also demands parenteral therapy to cover a broad range of potential pathogens and to achieve adequate deep tissue concentrations. Topical antibiotics alone are insufficient for gonococcal infection, and amoxicillin is generally ineffective due to resistance, while doxycycline is not the preferred choice for acute gonorrheal infection and would not reliably treat orbital cellulitis. In practice, ceftriaxone is often paired with additional measures to cover possible Chlamydia co-infection, but ceftriaxone remains the central, most appropriate systemic option for these conditions.