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.
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
Oral cephalosporins are no longer recommended for gonococcal infections
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