Appropriate CDC-Recommended Therapeutic Regimen.
Ann is a 32-year-old married female who presents to her nurse practitioner reporting lower abdominal pain, cramping, slight fever, and dysuria of 3 days duration.Appropriate CDC-Recommended Therapeutic Regimen.
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History includes:
LMP 2 weeks ago (regular)
Reports oral contraceptive use
Reports pain in lower abdomen with cramping and pain on urination for 3 days
Denies any GI problems, reports regular bowel movements.
Denies vaginal discharge
Ann is married and in a monogamous relationship. Has one child age 2
Reports no use of condoms/sexual intercourse 2-3 times per week
Denies any history of STDs
Physical Exam reveals:
Temp 100. 6, P 80 BP 100/62 Wt. 125 Ht. 5’3’’
HEENT WNL
No CVA tenderness
Pain in lower quadrants with light palpation. Positive inguinal lymphadenopathy
External genitalia without lesions or discharge
Pelvic exam reveals minimal cervical mucopus
Bimanual exam reveals uterine and adnexal tenderness and cervical motion pain. Uterus anterior, midline, smooth, not enlarged
1. Based on the above case the diagnosis is PID, What is an appropriate CDC-recommended therapeutic regimen for this patient?Appropriate CDC-Recommended Therapeutic Regimen.
Appropriate CDC-Recommended Therapeutic Regimen
There are 4 distinct clinical treatment regimens suggested by the CDC that would be suitable for Anne, and she is suitable for outpatient care because she lacks danger signs. Depending on the availability and expense of the drugs, therapeutic characteristics, client expectations or approval, and reactions, the preferred regimen may be established. Empirical, broad-spectrum surveillance of potentially causative agents is provided for all care regimens. Even if the screening indicates negative, all regimens should be efficient against C. trachomatis and N. gonorrhea, since a negative result would not rule out infection of the upper reproductive tract. To avoid persistent problems, the usage of regimens that encompass anaerobic microbes ought to be recommended. Once the presumptive diagnosis is done, therapy for PID should start as prompt treatment eliminates lasting problems (CDC, 2015).Appropriate CDC-Recommended Therapeutic Regimen.
Regimen A comprises IM ceftriaxone 250 milligrams (mg) once a day and oral doxycycline mg 100 mg twice daily for two weeks. Since metronidazole 500 mg covers trichomoniasis, BV, and other anaerobic pathogens responsible for causing PID, it is recommended to be taken orally twice daily. Regimen B comprises of one gram of oral probenecid and 2 grams of IM cefoxitin once daily, co-administered together. In regimen B, one hundred mg of oral doxycycline is also used two times a day for 2 weeks. Once more, for the same function as mentioned above, oral metronidazole should be recommended. Regimen C is a similar regimen as regimen B but, rather than doxycycline, 500 mg oral azithromycin should be used in regimen C for a period of one week followed by oral 250 mg. In the management of PID, research indicates that azithromycin could be preferable to doxycycline. Regimen D is much like regimen A, apart from that one gram of cefotaxime IM or IV every twelve hours or two grams of ceftizoxime IV every eight hours substitutes ceftriaxone. Metronidazole can also be included in regimen C and D and is taken at the same dosage and for the function similar to that of regimen A (Youngkin et al., 2013).Appropriate CDC-Recommended Therapeutic Regimen.