What is the recommended treatment for a 16-year-old female with pelvic inflammatory disease and a tubo-ovarian abscess?

The recommended treatment for a 16-year-old female with pelvic inflammatory disease (PID) and a tubo-ovarian abscess is hospitalization with parenteral doxycycline and cefoxitin. This approach is necessary due to the severity of the condition associated with a tubo-ovarian abscess, which typically requires more intensive treatment than can be provided on an outpatient basis.

Parenteral treatment allows for immediate and effective management of the infection, particularly in cases where there is a risk for complications like sepsis or the need for surgical intervention. Both doxycycline and cefoxitin are effective against the polymicrobial flora commonly involved in PID, including Neisseria gonorrhoeae and Chlamydia trachomatis, as well as anaerobic bacteria.

The choice of hospitalization also provides an opportunity for better monitoring of the patient's response to treatment, especially since abscesses can lead to significant morbidity if not managed appropriately. Serial evaluations can determine the need for additional interventions, such as surgical drainage if the abscess does not respond to antibiotic therapy.

Other treatment options may not be sufficient to manage the severity of the condition presented in this scenario; therefore, the necessity of hospitalization and aggressive management is underscored in this case.