Infectious Disease Q11

A 26-year-old woman is evaluated in the emergency department for lower abdominal pain with vaginal discharge. She reports no nausea or vomiting but noted vaginal bleeding after intercourse the previous night. She is sexually active, with two partners in the past 3 months, but she does not use condoms consistently. She has an intrauterine device for contraception and takes no medications.

On physical examination, vital signs are normal. Pelvic examination is shown; uterine and cervical motion tenderness are noted, but she has no adnexal tenderness or masses.

A urine pregnancy test is negative. Samples are obtained for nucleic acid amplification testing for Neisseria gonorrhoeae and Chlamydia trachomatis.

Which of the following is the most appropriate empiric treatment?

Oral amoxicillin-clavulanate plus oral doxycycline

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