A 25-year-old sexually active woman has lower abdominal pain, cervical motion tenderness, and mucopurulent cervical discharge. Her WBC is 13,000/mm³. According to CDC 2021 guidelines, empirical treatment for PID with outpatient management uses:
- A Ceftriaxone 500 mg IM single dose + doxycycline 100 mg BD × 14 days ± metronidazole 500 mg BD × 14 days ✓
- B Azithromycin 1 g single dose alone
- C Ciprofloxacin 500 mg BD × 14 days monotherapy
- D Amoxicillin-clavulanate 875 mg BD × 10 days
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 for outpatient PID recommend ceftriaxone 500 mg IM as a single dose (covering gonorrhoea, including higher doses for higher gonorrhoea prevalence settings), plus doxycycline 100 mg orally twice daily for 14 days (covering Chlamydia and other organisms), with optional addition of metronidazole 500 mg twice daily for 14 days if anaerobic coverage is required. Fluoroquinolone monotherapy is no longer recommended due to widespread gonococcal resistance.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.