Table 2.
Route of administration |
Antimicrobial regimen |
|||
---|---|---|---|---|
Parenteral component2 | Oral component | |||
Parenteral + oral | Regimen A | Cefotetan 2 g IV every 12 hours | Doxycycline 100 mg orally twice a day to complete a 14-day course PLUS, when tubo-ovarian abscess is present, | |
OR | PLUS | |||
Cefoxitin 2 g IV every 6 hours | ||||
PLUS | ||||
Doxycycline 100 mg orally or IV every 12 hours | ||||
Regimen B | Clindamycin 900 mg IV every 8 hours | PLUS | Clindamycin 450 mg orally four times a day to complete a 14-day course | |
PLUS | ||||
Gentamicin loading dose 2 mg/kg IV or IM, followed by a maintenance dose of 1.5 mg/kg every 8 hours. Single daily dosing (3–5 mg/kg) can be substituted | OR | |||
Alternative | Ampicillin/Sulbactam 3 g IV every 6 hours | |||
PLUS | PLUS | Metronidazole 500 mg orally two times a day tocomplete a 14-day course | ||
Doxycycline 100 mg orally or IV every 12 hours | ||||
Oral | Recommended | Ceftriaxone 250 mg IM in a single dose | ||
OR | ||||
Cefoxitin 2 g IM in a single dose and Probenecid, 1 g orally administered concurrently in a single dose | ||||
OR | ||||
Other parenteral third-generation cephalosporin | ||||
(eg, ceftizoxime or cefotaxime) | ||||
PLUS | ||||
Doxycycline 100 mg orally twice a day for 14 days | ||||
WITH or WITHOUT | ||||
Metronidazole 500 mg orally twice a day for 14 days | ||||
Alternative | Ceftriaxone 250 mg IM in a single dose | |||
PLUS | ||||
Azithromycin 1 g orally once a week for two weeks | ||||
WITH or WITHOUT | ||||
Metronidazole 500 mg orally twice a day for 14 days |
Notes:
Adapted from the 2010 CDC STD treatment guidelines;35
Parenteral treatment should be continued until 24 hours following the improvement of clinical symptoms.