Professional and Linguistic Assessments Board (PLAB) Practice Exam

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What is the standard outpatient treatment regimen for PID?

Ceftriaxone IM + doxycycline for 7 days
Ceftriaxone IM + metronidazole for 14 days
Ceftriaxone IM + doxycycline for 14 days +/- metronidazole
Ceftriaxone IM + clindamycin for 10 days

The correct answer is: Ceftriaxone IM + doxycycline for 14 days +/- metronidazole

The standard outpatient treatment regimen for pelvic inflammatory disease (PID) includes Ceftriaxone administered intramuscularly, combined with doxycycline taken orally for a duration of 14 days. The addition of metronidazole is optional, typically used to cover for anaerobic bacteria that may be involved in the infection. This combination is effective because it targets a range of pathogens that can cause PID, primarily sexually transmitted infections like Chlamydia trachomatis and Neisseria gonorrhoeae, while also covering anaerobic organisms. Doxycycline works as a tetracycline antibiotic, providing broad-spectrum coverage. The regimen's length of 14 days is essential to ensure an adequate treatment duration for effectively resolving the infection and preventing complications, such as chronic pelvic pain or infertility. The other treatment options do not align with the current guidelines for PID management. Other combinations, such as Ceftriaxone with metronidazole alone for a specific duration or with different antibiotics, may not adequately cover all potential pathogens associated with PID or may not meet the recommended treatment duration for optimal efficacy.