A 24-year-old woman with PID is started on outpatient treatment. Per CDC 2021 guidelines, which oral regimen is CURRENTLY preferred for outpatient PID treatment?
- A Ceftriaxone 500 mg IM single dose + doxycycline 100 mg BD × 14 days + metronidazole 500 mg BD × 14 days ✓
- B Cefixime 400 mg oral single dose + azithromycin 1 g single dose + metronidazole 500 mg BD × 14 days
- C Ofloxacin 400 mg BD × 14 days + metronidazole 500 mg BD × 14 days
- D Doxycycline 100 mg BD × 14 days alone for mild PID
Correct answer: A. Ceftriaxone 500 mg IM single dose + doxycycline 100 mg BD × 14 days + metronidazole 500 mg BD × 14 days
Explanation
CDC 2021 STI Treatment Guidelines: preferred outpatient PID regimen is ceftriaxone 500 mg IM (single dose) + doxycycline 100 mg twice daily × 14 days + metronidazole 500 mg twice daily × 14 days. The metronidazole provides anaerobic coverage for BV-associated organisms. Ceftriaxone dose was updated from 250 mg to 500 mg (1 g for weight ≥150 kg) in the 2021 guidelines. Fluoroquinolone-based regimens (ofloxacin/levofloxacin) remain alternative regimens but are no longer preferred due to fluoroquinolone resistance in Neisseria gonorrhoeae.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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