What is the recommended follow-up for a 20-year-old with a Pap smear showing significant inflammation?

In the context of a Pap smear showing significant inflammation, the most appropriate follow-up is to perform cervical cultures for gonorrhea. This is because significant inflammation can often signify an underlying infection, and gonorrhea is a common sexually transmitted infection that could lead to cervical inflammation. Cultures are essential for diagnosing infections accurately, enabling the healthcare provider to initiate appropriate treatment.

The other options do not directly address the need for a proper evaluation of potential infections. Prescribing metronidazole vaginal cream is typically indicated for bacterial vaginosis or trichomoniasis, not specifically for the inflammation noted in a Pap smear. Scheduling a repeat Pap smear in 6 months may not be warranted without understanding the cause of the inflammation—it may only delay necessary treatment if there is an underlying infection. Advising a Betadine douche is not recommended for managing inflammation; in fact, douches can disrupt normal vaginal flora and lead to further complications.

Thus, performing cervical cultures is crucial for identifying any infectious causes behind the significant inflammation, allowing for targeted treatment and better reproductive health outcomes.