Which antibiotic is most appropriate for treating acute epididymitis caused by Neisseria gonorrhoeae?

Ceftriaxone is the most appropriate antibiotic for treating acute epididymitis caused by Neisseria gonorrhoeae. This is due to its effectiveness as a broad-spectrum cephalosporin antibiotic that is particularly active against gram-negative bacteria, including Neisseria species. In the context of acute epididymitis, especially when there is a high suspicion of a sexually transmitted infection, Ceftriaxone is the recommended first-line treatment because it can effectively target the organism responsible for this infection.

Additionally, the administration of Ceftriaxone is often combined with another antibiotic, such as doxycycline, to cover potential co-infections such as Chlamydia trachomatis, which is also a common causative agent in cases of epididymitis. This dual approach helps ensure comprehensive treatment of the infection.

Ampicillin, while an antibiotic, is not the first choice in this context, as it has limited effectiveness against Neisseria gonorrhoeae. Ciprofloxacin, a fluoroquinolone, can be effective for treating certain bacterial infections, but it is not the preferred choice for gonorrheal infection, especially with rising resistance patterns. Nitrofurantoin is primarily used for urinary tract infections and is not suitable