Specific Organisms and Therapeutic Regimens
Organism-specific therapeutic regimens for cervicitis are provided below, including those for Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma genitalium and Trichomonas vaginalis.
Neisseria gonorrhoeae (gonococcal cervicitis)
Recommendations are as follows:
Ceftriaxone 250 mg IM in a single dose plus
Azithromycin 1 g PO in a single dose
If ceftriaxone is not available:
Cefixime 400 mg PO in a single dose plus
Azithromycin 1 g PO in a single dose
If patient has severe cephalosporin allergy:
Azithromycin 2 g PO in a single dose plus
Gemifloxacin 320 mg PO in a single dose or
Gentamicin 240 mg IM in a single dose
Test-of-cure in 1 week
Treatment failure should be considered in persons whose symptoms do not resolve within 3–5 days after appropriate treatment and persons with a positive test-of-cure, when no sexual contact is reported during the post-treatment follow-up period. Before retreatment, relevant clinical specimens should be obtained for culture and antimicrobial susceptibility testing if N. gonorrhoeae is isolated
Chlamydia trachomatis
Recommendations are as follows:
Azithromycin 1 g PO in a single dose or
Doxycycline 100 mg PO BID for 7 days
Alternative regimens:
Erythromycin base 500 mg PO QID for 7 days or
Erythromycin ethylsuccinate 800 mg PO QID for 7 days or
Ofloxacin 300 mg PO BID for 7 days or
Levofloxacin 500 mg PO once daily for 7 days
Mycoplasma genitalium
Recommendations are as follows:
Azithromycin 1 g PO in a single dose or
Moxifloxacin 400 mg PO daily for 7 days
Trichomonas vaginalis
Recommendations are as follows:
Metronidazole 2 g orally in a single dose or
Tinidazole 2 g orally in a single dose
Alternative regimen
Metronidazole 500 mg orally twice a day for 7 days*
* Patients should be advised to avoid consuming alcohol during treatment with metronidazole or tinidazole. Abstinence from alcohol use should continue for 24 hours after completion of metronidazole or 72 hours after completion of tinidazole.