Levofloxacin combined with azithromycin shows greater efficacy in cervicitis treatment compared to azithromycin monotherapy.

OBJECTIVE

To evaluate the efficacy of levofloxacin combined with azithromycin in the treatment of cervicitis and its effect on serum inflammatory markers.

METHODS

A retrospective analysis was conducted on the clinical records of 102 patients with cervicitis treated at Gansu Provincial Maternity and Child-care Hospital between March 2022 and March 2023. The control group (47 patients) received azithromycin, while the study group (55 patients) was treated with a combination of levofloxacin and azithromycin. Serum levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and C-reactive protein (CRP) were measured before treatment and after two weeks. The efficacy, adverse reaction rate, and recurrence of cervicitis over a 6-month follow-up period were analyzed. A multiple logistic regression was performed to identify factors influencing recurrence.

RESULTS

Prior to treatment, no significant differences were observed between the two groups in IL-6, TNF-α, or CRP levels (all P>0.05). After treatment, both groups showed significant reductions in these markers (all P<0.0001), with the study group exhibiting more pronounced decreases (P<0.0001). The overall response rate in the study group was significantly higher than that of the control group (P=0.041). No significant difference in the incidence of adverse reactions was found between the groups (P=0.551). The recurrence rate of cervicitis was significantly higher in the control group compared to the study group (P=0.022). Logistic regression analysis identified disease severity (P=0.014, OR: 8.616; CI: 1.543-48.096), post-treatment IL-6 (P=0.003, OR: 17.573; CI: 2.720-113.531), post-treatment CRP (P=0.039, OR: 5.731; CI: 1.089-30.157), and post-treatment TNF-α (P=0.001, OR: 20.547; CI: 3.210-131.518) as independent predictors of recurrence.

CONCLUSION

Levofloxacin combined with azithromycin is more effective than azithromycin monotherapy in treating cervicitis. The combination significantly reduces inflammatory responses and recurrence rates without increasing adverse effects, making it a valuable option for clinical use.