Cervicitis Organism-Specific Therapy
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Organism-specific therapeutic regimens for cervicitis are provided below, including those for Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma genitalium and Trichomonas vaginalis. [1, 2, 3, 4, 5, 6]
Recommendations are as follows:
Ceftriaxone 250 mg IM in a single dose plus
Azithromycin 1 g PO in a single dose
If ceftriaxone is not available:
Cefixime 400 mg PO in a single dose plus
Azithromycin 1 g PO in a single dose
If patient has severe cephalosporin allergy:
Azithromycin 2 g PO in a single dose plus
Gemifloxacin 320 mg PO in a single dose or
Gentamicin 240 mg IM in a single dose
Test-of-cure in 1 week
Treatment failure should be considered in persons whose symptoms do not resolve within 3–5 days after appropriate treatment and persons with a positive test-of-cure, when no sexual contact is reported during the post-treatment follow-up period. Before retreatment, relevant clinical specimens should be obtained for culture and antimicrobial susceptibility testing if N. gonorrhoeae is isolated
Recommendations are as follows:
Azithromycin 1 g PO in a single dose or
Doxycycline 100 mg PO BID for 7 days
Alternative regimens:
Erythromycin base 500 mg PO QID for 7 days or
Erythromycin ethylsuccinate 800 mg PO QID for 7 days or
Ofloxacin 300 mg PO BID for 7 days or
Levofloxacin 500 mg PO once daily for 7 days
Recommendations are as follows:
Azithromycin 1 g PO in a single dose or
Moxifloxacin 400 mg PO daily for 7 days
Recommendations are as follows:
Metronidazole 2 g orally in a single dose or
Tinidazole 2 g orally in a single dose
Alternative regimen
Metronidazole 500 mg orally twice a day for 7 days*
* Patients should be advised to avoid consuming alcohol during treatment with metronidazole or tinidazole. Abstinence from alcohol use should continue for 24 hours after completion of metronidazole or 72 hours after completion of tinidazole.
Centers for Disease Control and Prevention. Sexually Transmitted Diseases Treatment Guidelines, 2015. MMWR: Recommendations and Reports. June 5, 2015. 64(3):[Full Text].
Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2006. MMWR 2006. 55 (No. RR-11):
Centers for Disease Control and Prevention. Update to CDC’s sexually transmitted diseases treatment guidelines, 2006: fluoroquinolones no longer recommended for the treatment of gonococcal infections. MMWR 2007 Apr 13. 56(14):332-336.
Ollendorf AT. Cervicitis. Medscape Drugs & Diseases from WebMD. Available at http://emedicine.medscape.com/article/253402-overview. Updated: February 9, 2017; Accessed: February 13, 2017.
Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2010. MMWR 2010. 59 (No. RR-12):
CDC. Update to CDC’s Sexually transmitted diseases treatment guidelines, 2010: oral cephalosporins no longer a recommended treatment for gonococcal infections. MMWR Morb Mortal Wkly Rep. 2012 Aug 10. 61(31):590-4. [Medline].
Thomas E Herchline, MD Professor of Medicine, Wright State University, Boonshoft School of Medicine; Medical Consultant, Public Health, Dayton and Montgomery County (Ohio) Tuberculosis Clinic
Thomas E Herchline, MD is a member of the following medical societies: Alpha Omega Alpha, Infectious Diseases Society of America, Infectious Diseases Society of Ohio
Disclosure: Nothing to disclose.
Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference
Disclosure: Received salary from Medscape for employment. for: Medscape.
Nicole W Karjane, MD Associate Professor, Department of Obstetrics and Gynecology, Virginia Commonwealth University Medical Center
Nicole W Karjane, MD is a member of the following medical societies: American College of Obstetricians and Gynecologists, Association of Professors of Gynecology and Obstetrics, North American Society for Pediatric and Adolescent Gynecology
Disclosure: Received income in an amount equal to or greater than $250 from: Merck<br/>Served as Nexplanon trainer for: Merck.
Michael Stuart Bronze, MD David Ross Boyd Professor and Chairman, Department of Medicine, Stewart G Wolf Endowed Chair in Internal Medicine, Department of Medicine, University of Oklahoma Health Science Center; Master of the American College of Physicians; Fellow, Infectious Diseases Society of America; Fellow of the Royal College of Physicians, London
Michael Stuart Bronze, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, American Medical Association, Association of Professors of Medicine, Infectious Diseases Society of America, Oklahoma State Medical Association, Southern Society for Clinical Investigation
Disclosure: Nothing to disclose.
Cervicitis Organism-Specific Therapy
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