Cervicitis Empiric Therapy 

  • Author: Thomas E Herchline, MD; Chief Editor: Michael Stuart Bronze, MD   more...
 
Updated: Jun 14, 2011
 
 

Empiric Therapy Regimens

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]

Presumptive treatment

  • 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
  • Cefixime 400 mg PO in a single dose 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

Recurrent and persistent cervicitis

  • 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

Management of pregnant patients with nongonococcal cervicitis

  • 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
 
Contributor Information and Disclosures
Author

Thomas E Herchline, MD  Professor of Medicine, Wright State University Boonshoft School of Medicine; Medical Director, Public Health, Dayton and Montgomery County, Ohio

Thomas E Herchline, MD is a member of the following medical societies: Alpha Omega Alpha, Infectious Diseases Society of America, and Infectious Diseases Society of Ohio

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Chief Editor

Michael Stuart Bronze, MD  Professor, Stewart G Wolf Chair in Internal Medicine, Department of Medicine, University of Oklahoma Health Science Center

Michael Stuart Bronze, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physician Executives, American College of Physicians, American College of Physicians-American Society of Internal Medicine, American Federation for Clinical Research, American Medical Association, American Society for Microbiology, Association of Professors of Medicine, Association of Program Directors in Internal Medicine, Infectious Diseases Society of America, Oklahoma State Medical Association, and Southern Society for Clinical Investigation

Disclosure: Nothing to disclose.

References
  1. Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2006. MMWR 2006;55 (No. RR-11).

  2. 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.

  3. Ollendorf AT. Cervicitis. Medscape Reference [serial online]. Available from: WebMD. Accessed Nov 4, 2010. Available at http://emedicine.medscape.com/article/253402-overview.

  4. Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2010. MMWR 2010;59 (No. RR-12).

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