Continue only vancomycin until culture and susceptibilities available.
Suspect Neisseria gonorrhea. Take a complete sexual history and perform testing for sexually transmitted infections.
Discontinue vancomycin. Continue ceftriaxone only.
AND
If gonococcal infection confirmed, also give:
Azithromycin 1g PO x 1 dose for pre-emptive treatment of chlamydial infection.
Discontinue vancomycin. Continue ceftriaxone only until culture and susceptibilities available.
Guidelines