Cervicitis medical therapy: Difference between revisions

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===Gonococcal Cervicitis Treatment===
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! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center |{{fontcolor|#FFF|Gonococcal Cervicitis Treatment}}
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| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen‡'''''
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| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Ceftriaxone]]  250 mg IM x 1 dose'''''
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| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | PLUS
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| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Azithromycin]] 1 gm PO x 1 dose for 7 days'''''
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| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | OR
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| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Doxycycline]] 100 mg po q12h for 7 days '''''
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| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Alternative Regimen'''''
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| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Azithromycin]] 2 gm po x 1 dose'''''
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| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | OR '''[[Cephalosporins]]''' single dose
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| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Ceftizoxime]] 500 mg IM''''' <BR> OR <BR> ▸ '''''[[Cefotaxime]] 500 mg IM''''' <BR> OR <BR> ▸'''''[[Cefoxitin]] 2 gm IM + [[Probenecid]] 1 gm po'''''<BR> OR <BR> ▸ '''''[[Cefixime]] 400 mg po¶''''' 
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| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | PLUS
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| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Azithromycin]] 1 gm PO x 1 dose'''''OR'''''[[Doxycycline]] 100 mg po q12h x 7 days'''''
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| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | OR
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| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Spectinomycin]]<sup>NUS</sup> 2 gm IM x 1 dose'''''
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| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Failure of treatment†
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| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Ceftriaxone]] 500 mg IM x 1 dose'''''
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| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | PLUS
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| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left |  ▸ '''''[[Azithromycin]] 2 gm po x 1dose'''''
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‡Use combination therapy even if NAAT test is negative for Chlamydiae.<br>
†Treat sex partner, repeat NAAT test after 1 week of cure.<br>
¶If IM cephalisporins are not available.
Proper perineal hygiene should be stressed.  This includes avoiding use of vaginal deodarant sprays and proper wiping after urination and bowel movements.  Intercourse should be avoided until symptoms subside.


==References==
==References==

Revision as of 21:58, 3 February 2014

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Overview

Antibiotics are used to treat bacterial infections, such as chlamydia, gonorrhea, and others. Drugs called antivirals may be used to treat herpes infections. Hormonal therapy (with estrogen or progesterone) may be used in women who have reached menopause (postmenopausal). When these treatments have not worked or when cervicitis has been present for a long time, treatment may include cryosurgery (freezing), electrocauterization, or laser therapy.

Nongonococcal Cervicitis Treatment

Nongonococcal Cervicitis Treatment
Preferred Regimen
Doxycycline 100 mg bid po x 7 days
OR
Azithromycin 1 gm po as single dose
Pregnancy
Erythromycin 500 mg po qid x 7 days
OR
Amoxicillin 500 mg po tid x 7 days
Alternative Regimen
Erythromycin 500 mg qid po x 7 days
OR
Ofloxacin 300 mg q12h po x 7 days
OR
Levofloxacin 500 mg q24h x 7 days
Pregnancy
Azithromycin 1 gm po single dose

Gonococcal Cervicitis Treatment

Gonococcal Cervicitis Treatment
Preferred Regimen‡
Ceftriaxone 250 mg IM x 1 dose
PLUS
Azithromycin 1 gm PO x 1 dose for 7 days
OR
Doxycycline 100 mg po q12h for 7 days
Alternative Regimen
Azithromycin 2 gm po x 1 dose
OR Cephalosporins single dose
Ceftizoxime 500 mg IM
OR
Cefotaxime 500 mg IM
OR
Cefoxitin 2 gm IM + Probenecid 1 gm po
OR
Cefixime 400 mg po¶
PLUS
Azithromycin 1 gm PO x 1 doseORDoxycycline 100 mg po q12h x 7 days
OR
SpectinomycinNUS 2 gm IM x 1 dose
Failure of treatment†
Ceftriaxone 500 mg IM x 1 dose
PLUS
Azithromycin 2 gm po x 1dose

‡Use combination therapy even if NAAT test is negative for Chlamydiae.
†Treat sex partner, repeat NAAT test after 1 week of cure.
¶If IM cephalisporins are not available.

Proper perineal hygiene should be stressed. This includes avoiding use of vaginal deodarant sprays and proper wiping after urination and bowel movements. Intercourse should be avoided until symptoms subside.

References

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