Metronidazole is included in the standard oral outpatient regimen for pelvic inflammatory disease primarily because it provides:
- A Coverage of anaerobes and bacterial vaginosis associated organisms ✓
- B Enhanced activity against Chlamydia trachomatis
- C Prevention of ceftriaxone resistance in Neisseria gonorrhoeae
- D Treatment of coexisting Trichomonas vaginalis only
Correct answer: A. Coverage of anaerobes and bacterial vaginosis associated organisms
Explanation
Anaerobes such as Bacteroides species and organisms linked to bacterial vaginosis participate in polymicrobial upper genital tract infection, and metronidazole covers them where ceftriaxone and doxycycline do not. Doxycycline already handles chlamydia, so option B adds nothing. Metronidazole does not influence gonococcal cephalosporin resistance, and although it treats trichomoniasis incidentally, that is not the rationale for its inclusion in PID regimens.
Reference: CDC STI Treatment Guidelines, 2021 ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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