A 26-year-old woman is diagnosed with mild PID (no tubo-ovarian abscess) in an outpatient setting. According to CDC 2021 STI treatment guidelines, which outpatient regimen is recommended?

• A Ceftriaxone 500 mg IM single dose plus doxycycline 100 mg orally twice daily for 14 days, with or without metronidazole 500 mg twice daily for 14 days ✓
• B Azithromycin 1 g orally stat plus doxycycline 100 mg for 7 days
• C Ciprofloxacin 500 mg twice daily plus metronidazole 400 mg twice daily for 7 days
• D Ofloxacin 400 mg twice daily alone for 14 days

Explanation

CDC 2021 recommends ceftriaxone 500 mg IM as a single dose (increased from 250 mg to cover cephalosporin-resistant gonococcus) plus oral doxycycline 100 mg twice daily for 14 days, with metronidazole 500 mg twice daily for 14 days added to cover anaerobes and bacterial vaginosis-associated organisms. Azithromycin monotherapy is insufficient for PID. Fluoroquinolones (ofloxacin, ciprofloxacin) are no longer recommended by CDC for gonorrhoea-associated PID due to widespread resistance.

Reference: Shaw's Textbook of Gynaecology, 17th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.