A 16-year-old sexually active female with fever, bilateral lower abdominal pain, and malaise. A speculum and bimanual exam reveals adnexal tenderness. The urinalysis is normal and cervical cultures are pending. What medications will the primary care pediatric nurse practitioner prescribe for this patient?

A 16-year-old sexually active female with fever, bilateral lower abdominal pain, and malaise. A speculum and bimanual exam reveals adnexal tenderness. The urinalysis is normal and cervical cultures are pending. What medications will the primary care pediatric nurse practitioner prescribe for this patient?

• A. Azithromycin, doxycycline, and penicillin
• B. Cefotaxime, azithromycin, and penicillin
• C. Ceftriaxone, doxycycline, and metronidazole
• D. Doxycycline, penicillin, and metronidazole

Answer: (C)

This question centers on empiric treatment of pelvic inflammatory disease to prevent infertility and other complications. In a sexually active adolescent with fever, bilateral lower abdominal pain, malaise, and adnexal tenderness, PID is suspected, and prompt broad-spectrum therapy is essential. The best approach combines coverage for gonorrhea, chlamydia, and anaerobes. Ceftriaxone provides gonorrhea coverage, doxycycline treats Chlamydia, and metronidazole adds anaerobic coverage. This trio addresses the most common pathogens involved in PID and aligns with outpatient regimens for nonpregnant patients who can take oral medications. Omitting any one of these components would leave a significant pathogen unaddressed, reducing the effectiveness of therapy and increasing the risk of complications.

This question centers on empiric treatment of pelvic inflammatory disease to prevent infertility and other complications. In a sexually active adolescent with fever, bilateral lower abdominal pain, malaise, and adnexal tenderness, PID is suspected, and prompt broad-spectrum therapy is essential.

The best approach combines coverage for gonorrhea, chlamydia, and anaerobes. Ceftriaxone provides gonorrhea coverage, doxycycline treats Chlamydia, and metronidazole adds anaerobic coverage. This trio addresses the most common pathogens involved in PID and aligns with outpatient regimens for nonpregnant patients who can take oral medications. Omitting any one of these components would leave a significant pathogen unaddressed, reducing the effectiveness of therapy and increasing the risk of complications.