Cervicitis Empiric Therapy 

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Empiric therapeutic regimens for cervicitis are outlined below, including presumptive treatment, treatment for recurrent and persistent cervicitis, and treatment for pregnant patients with nongonococcal cervicitis. ^{[1, 2, 3, 4, 5, 6, 7, 8]}

See the list below:

Azithromycin 1 g PO in a single dose or

Doxycycline 100 mg PO BID for 7d (contraindicated during pregnancy)

Consider the addition of concurrent treatment for gonococcal infection if prevalence of gonorrhea is high in the patient population under assessment:

Ceftriaxone 250 mg IM in a single dose (strongly preferred) or

Ceftizoxime 500 mg IM in a single dose or

Cefotaxime 500 mg IM in a single dose or

Cefoxitin 2 g IM plus probenecid 1 g PO in a single dose

Fluoroquinolones should not be used as empiric therapy because of increasing resistance of Neisseria gonorrhoeae isolates ^{[2, 4]}

Oral cephalosporins are no longer recommended for gonococcal infections ^[6]

See the list below:

Reevaluate for possible reexposure to a sexually transmitted disease, and reassess patient for potential bacterial vaginosis

Important to assess, manage, and treat partners

Management of persistent cervicitis of unknown etiology is undefined

See the list below:

Erythromycin base 500 mg PO QID for 7d or

Erythromycin ethylsuccinate 800 mg PO QID for 7d or

Amoxicillin 500 mg PO TID for 7d

Doxycycline and fluoroquinolones are contraindicated during pregnancy

Workowski KA, Bolan GA, Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep. 2015 Jun 5. 64 (RR-03):53-55. [Medline].

Centers for Disease Control and Prevention. 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 Reference. [Full Text].

[Guideline] Centers for Disease Control and Prevention (CDC). Update to CDC’s sexually transmitted diseases treatment guidelines, 2006: fluoroquinolones no longer recommended for treatment of gonococcal infections. MMWR Morb Mortal Wkly Rep. 2007 Apr 13. 56(14):332-6. [Medline]. [Full Text].

Workowski KA, Berman S. Sexually transmitted diseases treatment guidelines, 2010. MMWR Recomm Rep. 2010 Dec 17. 59:1-110. [Medline].

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].

Massad LS, Einstein MH, Huh WK, et al, for the 2012 ASCCP Consensus Guidelines Conference. 2012 updated consensus guidelines for the management of abnormal cervical cancer screening tests and cancer precursors. Obstet Gynecol. 2013 Apr. 121(4):829-46. [Medline].

American College of Obstetricians and Gynecologists. Practice Bulletin No. 140: management of abnormal cervical cancer screening test results and cervical cancer precursors. Obstet Gynecol. 2013 Dec. 122(6):1338-67. [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.

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 Empiric Therapy 

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