What is the most effective way to manage chronic cervicitis?

Question

Hello doctor,

I have chronic cervicitis. I took the following medications for seven days: Azithromycin 500 mg (twice daily), Secnidazole 1000 mg (twice daily), and Fluconazole 150 mg (twice daily). After completing the course, I stopped the medications, but three days later, white discharge and itching reappeared.

Additionally, I am experiencing nausea, dizziness, and a bitter taste, which are likely side effects of Azithromycin and Secnidazole. Should I restart the medications, or do I need stronger antibiotics or antifungals?

Please advise.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Chronic cervicitis is an inflammation of the cervix, the lower, narrow end of the uterus that opens into the vagina. Symptoms include per vaginal discharge, irregular menstrual bleeding, intermenstrual bleeding, dyspareunia, and lower abdominal pain. Often, cervicitis results from sexually transmitted infections, such as chlamydia and gonorrhea, but it can also develop from non-infectious causes.

Before starting the treatment, you were supposed to do a high vaginal swab to confirm the organism causing the discharge and its antibiotic sensitivity. Based on that, we would prescribe the appropriate antibiotics. However, you have already taken one week of empirical antibiotics. We should extend the course to two weeks, as the standard treatment for PID (pelvic inflammatory disease) is typically given for two weeks. The treatment plan includes an injection of Ceftriaxone 1g twice a day for two days, followed by Azithromycin 500 mg twice a day for seven days, and Doxycycline 100 mg twice a day for seven days.

I believe antifungal treatment is sufficient for one dose, as long-term use can cause liver toxicity. I will prescribe vaginal antifungal Clotrimazole 100 mg, to be taken one tablet at night via the vagina for seven days. Consult your specialist doctor, discuss with him or her, and take the medicines with their consent.

I hope this helps you.

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

If you are allergic to Azithromycin, stop taking it and do not continue with it. I would suggest the following medication:

Tablet Metronidazole 400 mg, three times a day for 14 days.
Tablet Doxycycline 100 mg, two times a day for 14 days.

Consult your specialist doctor, discuss with him or her, and take the medicines with their consent.

I hope this helps you.

Thank you.