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7/29/21, 4:01 PM

Robert Freter

A 25 y.o. primgravid female comes into your clinc with a chief complaint of abdominal pain. She says that this pain has lasted for 3-days and she recently had sexual intercourse with her boyfriend of 2 months. She endorses inconsistent condom use. Her temperature is 101.8 F, pulse is 86, and her BP is 112/30. Physical exam reveals lower abdominal pain, purulent vaginal discharge, and cervical motion tenderness.

Oral metronidazole

Oral doxycycline

IM ceftriaxone

IM ceftriaxone and PO doxyxline

Correct Answer:

D

Combination therapy with intramuscular ceftriaxone and oral doxycycline is the first-line treatment for Pelvic inflammatory disease which can cause purulent milky vaginal discharge, which requires combination therapy because it is often caused by multiple bacteria. The two most commonly isolated pathogens are Gonococcus and C. trichomatis. Ceftriaxone IM single dose is used fort Gonoccocus, while doxycycline provides coverage of C. trachomatis.

Reference: Centers for Disease Control and Prevention. Pelvic Inflammatory Disease (PID) Statistics. https://www.cdc.gov/std/pid/stats.htm.Updated: January 26, 2017.