The patient has more than a simple cervicitis. These findings are consistent with pelvic inflammatory disease (PID) and merit more aggressive therapy. A case could be made for admitting the patient, though outpatient management might also be acceptable. Studies have shown that fertility is better preserved with IV therapy. Suggested regimens are as follows:

Outpatient management:

Regimen A: Cefoxitin 2gm IM, plus probenecid 1gm PO; or ceftriaxone 250mg IM; all as single doses; plus doxycycline 100 mg PO BID for 14 days.

Regimen B: Ofloxacin 400mg PO IBD for 14 days, plus either clindamycin 450mg PO QID for 14 days, or metronidazole 500 mg PO BID for 14 days.

Inpatient management

Regimen A: Cefoxitin 2gm IV q6hr, or cefotetan 2gm IV q12hr; plus doxycycline 100mg IV or PO q12hr.

Regimen B: Clindamycin 900mg IV q8hr, plus gentamicin 2mg/kg loading dose IV or IM followed by 1.5mg/kg q8hr.

{Ref: Hooper C. New treatment guidelines for bacterial sexually transmitted diseases. Res & Staff Phys Supplement, Dec. 1993, pp. 6 - 11}