Cervicitis Empiric Therapy 

Updated: Mar 09, 2016
Author: Thomas E Herchline, MD; Chief Editor: Michael Stuart Bronze, MD 

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, 5, 6, 7, 8]

Presumptive treatment

See the list below:

  • 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

  • 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[2, 4]

  • Oral cephalosporins are no longer recommended for gonococcal infections[6]

Recurrent and persistent cervicitis

See the list below:

  • 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

See the list below:

  • 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