Final answer:
Azithromycin is active against N. gonorrhoeae and is used with ceftriaxone as recommended by the CDC. Penicillin's effectiveness has diminished due to resistance, and ciprofloxacin is no longer a first-line treatment due to resistance as well.
Step-by-step explanation:
Among the options provided, azithromycin is active against N. gonorrhoeae, and it is often used in combination with cephalosporins like ceftriaxone for treating gonorrhea infections. Although penicillin was traditionally effective against gonorrhea, the rise of antibiotic resistance has reduced its efficacy for this purpose. Ciprofloxacin, a fluoroquinolone, is no longer recommended as a first-line treatment for gonorrhea due to widespread resistance. The Centers for Disease Control and Prevention (CDC) currently recommends a combination regimen of ceftriaxone and azithromycin to treat gonorrhea, especially because co-infection with C. trachomatis is common. This dual treatment strategy helps manage the potential for antibiotic-resistant strains of gonorrhea and covers potential co-infection with chlamydia.