Abstract
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.