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Pelvic Inflammatory Disease — USMLE Step 2 CK MCQ

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MediumInfectious DiseasesPelvic Inflammatory DiseaseUSMLE Step 2 CK

A 23‑year‑old woman with lower abdominal pain, cervical motion tenderness, and mucopurulent discharge is diagnosed with pelvic inflammatory disease and can be treated as an outpatient. What is the recommended regimen?

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Correct answer: B — Ceftriaxone 500 mg IM once + doxycycline 100 mg bid for 14 days + metronidazole 500 mg bid for 14 days

CDC recommends ceftriaxone 500 mg IM once plus doxycycline and metronidazole for 14 days. Lower ceftriaxone dose (A) is outdated and lacks metronidazole. Doxycycline alone (C) is insufficient. Fluoroquinolone regimens (D) are generally not recommended due to resistance. Single-dose metronidazole (E) is inadequate for PID.

Reference: CDC STI Treatment Guidelines (2021): Pelvic Inflammatory Disease