This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: S.T.D., Subject name: Skin
A patient suspected of both gonococcal and non gonococcal urethritis. Drug of choice in such patient? 
Select and explain. 
A. Cefixime 400 mg stat, B. Azithromycin 2 gm stat, C. Ceftriaxone 250 mg stat, D. Doxycycline 100 BD
B: Azithromycin 2 gm stat
Answer: B: Azithromycin 2 gm stat 
Explanation: Ans. b. Azithromycin 2 gm statMonotherapy with 2 g oral azithromycin has been proven to be effective in patients with noncomplicated gonorrheal infections, but this is no longer recommended because of concerns of resistance to macrolides and documented treatment failures.Given the growing resistance patterns of gonorrhea, dual antibiotic therapy is recommended for treatment. First line recommendations for uncomplicated gonococcal infection of the vagina, cervix or rectum are "ceftriaxone 250 mg IM once plus azithromycin 1 g orally once". In cases of gonococcal conjunctivitis or disseminated gonococcal infections, the dose of ceftriaxone should be increased to 1 g IM single dose plus 1 g oral azithromycin once. A single 2 g oral dose of extended-release azithromycin for treatment of gonococcal urethritis.Ref. Journal of Antimicrobial Chemotherapy, Volume 69, Issue 11, 1 November 2014. Pages 3116-3118.