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Cervicitis Organism-Specific Therapy

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.

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