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Gynaecology & Obstetrics Infections of the genital tract 0ba3932a

A 30-year old female complains of lower abdominal pain and purulent vaginal discharge. Her pulse rate is 98/min, temperature is 101oF, WBC and ESR are raised. Per vaginal examination reveals lower abdominal tenderness and cervical motion tenderness. What is the best treatment option for her?

A
Single IM injection of Ceftriaxone with oral doxycycline and oral metronidazole for 14 days
B
Single dose of Ceftriaxone injection with oral Azithromycin for 14 days
C
Oral Metranidazole for 14 days
D
Oral Oflaxacin and oral Metronidazole for 14 days
High-Yield Explanation
The best treatment is single IM injection of Ceftrixone with oral Doxycycline and oral metronidazole for 14 days. The diagnosis is pelvic inflammatory disease. Sexually transmitted organisms especially N.gonorrhoeae and C.trachomatis are implicated in many cases. The best treatment for OPD management of PID is: Inj. Ceftrixone 250mg IM single dose + Doxycycline 100 mg BD * 14 days +/- Metronidazole 500 mg BD * 14 days Best parenteral treatment for PID is : Inj. Cefotetan 2g IV BD + Doxycycline 100 mg BD or Inj. Cefoxitin 2g QID+ Doxycycline 100 mg BD To minimize disease transmission, women should be instructed to abstain from sexual intercourse until therapy is completed, symptoms have resolved, and sex paners have been adequately treated. Ref: Online resources

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