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Management and Treatment of Cervicitis: A Review of Clinical Effectiveness and Guidelines

Last updated: September 21, 2017
Project Number: RC0926-000
Product Line: Rapid Response
Research Type: Drug
Report Type: Summary with Critical Appraisal
Result type: Report

Question

  1. What is the comparative clinical effectiveness of doxycycline versus azithromycin for the treatment of non-pregnant women with cervicitis caused by Neisseria gonorrhoeae, Chlamydia trachomatis, and Mycoplasma genitalium?
  2. What is the clinical effectiveness of using a test-and-wait approach for the management of non-pregnant women with diagnosed cervicitis?
  3. What are the evidence-based guidelines regarding the management and treatment of cervicitis in non-pregnant women?

Key Message

Evidence regarding the comparative clinical effectiveness of doxycycline versus azithromycin for the treatment of non-pregnant women with cervicitis caused by Neisseria gonorrhoeae, Chlamydia trachomatis, and Mycoplasma genitalium suggested that azithromycin was more effective at achieving both microbiological and clinical cure. It is important to note that this evidence was limited to one non-randomized study.Regarding cervicitis treatment management strategies, evidence from one randomized controlled trial favoured using a test-and-wait approach over presumptive treatment in non-pregnant women with cervicitis of unknown etiology.The evidence-based guidelines recommended azithromycin or doxycycline (alone or in combination with cephalosporins) for cervicitis of unknown etiology. One guideline stated that presumptive treatment for Chlamydia trachomatis and Neisseria gonorrhoea should be provided to women at high risk for these sexually transmitted infections. Alternatively, deferring treatment until results of diagnostic tests are available is an option for women at lower risk of sexually transmitted diseases.