PID - aftercare; Oophoritis - aftercare; Salpingitis - aftercare; Salpingo - oophoritis - aftercare; Salpingo - peritonitis - aftercare; STD - PID aftercare; Sexually transmitted disease - PID aftercare; GC - PID aftercare; Gonococcal - PID aftercare; Chlamydia - PID aftercare Laparoscopy is performed when less-invasive surgery is desired. It is also called Band-Aid surgery because only small incisions need to be made to accommodate the small surgical instruments that are used to view the abdominal contents and perform the surgery. To fully treat PID, you may need to take one or more antibiotics. Taking antibiotic medicine will help clear the infection in about 2 weeks. To prevent PID from coming back, your sexual partner must be treated as well. Side Effects of TreatmentAntibiotics can have side effects, including:
Let your provider know if you experience any side effects. Do not cut back or stop taking your medicine without talking with your doctor. Antibiotics kill the bacteria that cause PID. But they also kill other types of helpful bacteria in your body. This can cause diarrhea or vaginal yeast infections in women. Probiotics are small organisms found in yogurt and some supplements. Probiotics are thought to help friendly bacteria grow in your gut. This may help prevent diarrhea. However, studies are mixed about the benefits of probiotics. You can try eating yogurt with live cultures or taking supplements to help prevent side effects. Be sure to tell your provider if you take any supplements. Prevent Future Infections with Safe sexThe only sure way to prevent an STI is to not have sex (abstinence). But you can reduce your risk of PID by:
When to Call the DoctorCall your provider if:
ReferencesBeigi RH. Infections of the female pelvis. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 109. Richards DB, Taha J. Pelvic inflammatory disease. In: Bakes KM, Buchanan JA, Moreira ME, Byyny R, Pons PT, eds. Emergency Medicine Secrets. 7th ed. Philadelphia, PA: Elsevier; 2022:chap 78. Smith RP. Pelvic inflammatory disease (PID). In: Smith RP, ed. Netter's Obstetrics and Gynecology. 3rd ed. Philadelphia, PA: Elsevier; 2018:chap 155. Workowski KA, Bachmann LH, Chan PA, et al. Sexually Transmitted Infections Treatment Guidelines, 2021. MMWR Recomm Rep. 2021;70(4):1-187. PMID: 34292926 pubmed.ncbi.nlm.nih.gov/34292926/. Version InfoLast reviewed on: 1/10/2022 Reviewed by: John D. Jacobson, MD, Department of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.  Journal Article Catherine L. Haggerty, University of Pittsburgh , Pittsburgh, Pennsylvania Reprints or correspondence: Dr. Catherine L. Haggerty, Dept. of Reproductive Epidemiology, 130 DeSoto St., 516B Parran Hall, University of Pittsburgh, Pittsburgh, PA 15261 (). Search for other works by this author on: Roberta B. NessUniversity of Pittsburgh , Pittsburgh, Pennsylvania Search for other works by this author on: Accepted: 06 November 2006
Close Navbar Search Filter Microsite Search Term Search AbstractTreatment of pelvic inflammatory disease (PID) should provide high rates of clinical and microbiological cure for a range of pathogens and should ultimately prevent reproductive morbidity. Between 1992 and 2006, 5 randomized clinical trials of moxifloxacin (1 trial), ofloxacin (1 trial), clindamycin-ciprofloxacin (1 trial), and azithromycin (2 trials) treatment among women with mild to moderate PID were found to have clinical cure rates of 90%–97%. Trials of ofloxacin and clindamycin-ciprofloxacin reported rates of cure of Neisseria gonorrhoeae and Chlamydia trachomatis infection of 100%, although microbiological cure data for other pathogens were not presented. One azithromycin trial reported a 98% eradication of C. trachomatis, N. gonorrhoeae, Mycoplasma hominis, and anaerobes. Moxifloxacin exhibited high eradication rates for N. gonorrhoeae, C. trachomatis, M. hominis, Mycobacterium genitalium, and gram-negative anaerobes. Clinical cure rates from 2 doxycycline-metronidazole trials were low (35% and 55%). Although a handful of studies have shown that monotherapies for PID achieve high rates of clinical cure, the efficacy of these regimens in treating anaerobic PID and in preventing adverse reproductive sequelae is not fully elucidated. Pelvic inflammatory disease (PID), the infection and inflammation of a woman's upper genital tract, is a frequent cause of infertility, ectopic pregnancy, and chronic pelvic pain among women of childbearing age [1]. Surveillance data are sparse but suggest that PID is diagnosed in general practice in 1.7% of women aged 16–46 years in the United Kingdom annually and in ∼8% of US women and 15% of Swedish women in their lifetime, with >1 million US women treated annually [2–6]. PID is thought to occur when microorganisms, frequently Chlamydia trachomatis or Neisseria gonorrhoeae, ascend from the lower genital tract and infect the uterus, fallopian tubes, and ovaries [7]. However, PID has a multimicrobial etiology, and up to 70% of cases are nongonococcal and nonchlamydial. Anaerobic gram-negative rods, Mycoplasma genitalium, and bacterial vaginosis are also associated with PID [8–12]. Because of its polymicrobial nature, PID is treated with antibiotics covering a broad spectrum of pathogens. Guidelines of the Centers for Disease Control and Prevention recommend outpatient treatment of PID with ofloxacin, levofloxacin, ceftriaxone plus doxycycline, or cefoxitin and probenecid plus doxycycline, all with optional metronidazole for full coverage against anaerobes and bacterial vaginosis (table 1) [13]. In a meta-analysis of 34 treatment trials published primarily between 1985 and 1992, 4 inpatient regimens and 1 outpatient regimen were found to have pooled clinical cure rates ranging from 92% to 95% and microbiological cure rates ranging from 91% to 100% [14]. These inpatient regimens included the following drugs: clindamycin and aminoglycoside (clinical cure rate, 92%; microbiological cure rate, 97%); cefoxitin and doxycycline (clinical cure rate, 93%; microbiological cure rate, 98%); cefotetan and doxycycline (clinical cure rate, 94%; microbiological cure rate, 100%); and ciprofloxacin (clinical cure rate, 94%; microbiological cure rate, 96%) [15]. A fifth inpatient regimen, which included metronidazole and doxycycline, was found to have much lower rates of clinical and microbiological cure (75% and 71%, respectively) [14]. These low efficacy rates are likely attributable to the poor coverage of this latter combination against N. gonorrhoeae [15]. One outpatient regimen (cefoxitin, probenecid, and doxycycline) was included in this meta-analysis and was found to have a pooled clinical cure rate of 95% and a microbiological cure rate of 91% [14]. Since the publication of this meta-analysis, additional studies of PID treatment have been conducted, including several new monotherapies. Here, we summarize and evaluate these recent randomized clinical trials. Table 1 2006 US Centers for Disease Control and Prevention–recommended outpatient regimens for the treatment of pelvic inflammatory disease. Fluoroquinolone TrialsTwo nonrandomized studies of laparoscopically confirmed salpingitis similarly support the efficacy of ofloxacin for the treatment of gonococcal and chlamydial PID by demonstrating that ofloxacin, administered every 12 h intravenously followed by a 10- to 14-day oral regimen, was associated with a gonococcal cure rate of 100% [23, 24], a chlamydial cure rate of almost 100% [23, 24], and a clinical cure rate of 98% [24]. However, although all patients with anaerobic bacteria cultured at study admission were considered to be clinically cured at follow-up in one of these studies [24], follow-up anaerobic cultures were not reported, and therefore, microbiological cure of anaerobes cannot be determined. Because the lack of anaerobic coverage with ofloxacin is a concern, emphasized by the high rate of treatment failure among patients with nongonococcal, nonchlamydial PID [16], the Centers for Disease Control and Prevention suggests the optional addition of metronidazole [13]. Alternatively, a randomized clinical trial of 131 women with laparoscopically confirmed PID investigated the regimen of another fluoroquinolone, ciprofloxacin, plus clindamycin [17]. In this study, clindamycin-ciprofloxacin was found to be as effective as ceftriaxone plus doxycycline for the clinical cure of PID (97% vs. 95%) and C. trachomatis eradication (100% in both groups) [17]. N. gonorrhoeae was less prevalent; it was found in only 2 women who were treated with clindamycin plus ciprofloxacin, and 1 of these women achieved microbiological cure (a cure rate of 50%). Although aerobic and anaerobic isolates were frequently identified before treatment, no comparisons of microbiological cure for these pathogens were presented. In the most recent fluoroquinolone randomized clinical trial by Ross et al. [18], moxifloxacin was found to have high rates of clinical resolution (90%) and microbiological cure. The microbiological cure rate was 100% for N. gonorrhoeae, Mycoplasma hominis, M. genitalium, Escherichia coli, and other gram-negative anaerobes. Although the eradication rate of C. trachomatis was lower (89%), it was slightly higher than that of the comparator regimen (86%) [18]. Further, the eradication rate for N. gonorrhoeae was much higher (100%, compared with 82%) and the rate of drug-related adverse events was lower (23%, compared with 31%) among women treated with moxifloxacin. Azithromycin TrialsAlso of interest because of its association with enhanced compliance, single-dose or short-duration azithromycin in the treatment of PID has been examined in a handful of studies. Not surprisingly, compliance with single-dose azithromycin therapy has been reported to be 100% [25]. In a randomized clinical trial from India of 165 women with clinically suspected PID, a kit containing 1 tablet of fluconazole (150 mg), 1 tablet of azithromycin (1 g), and 2 tablets of secnidazole (2 g) was associated with a PID clinical cure rate of 93%, which is similar to that found among a group treated with ciprofloxacin plus tinidazole for 7 days (clinical cure rate, 96%) and better than that found among women treated with doxycycline plus metronidazole for 1 week (clinical cure rate, 91%) [19]. However, although this trial showed high rates of clinical cure, data on microbiological cure were not presented. In a randomized clinical trial in the United Kingdom that compared azithromycin monotherapy, azithromycin plus metronidazole, and standard 21-day regimens of metronidazole-doxycycline-cefoxitin-probenecid or doxycycline-amoxicillin-clavulanate among 300 patients with PID, azithromycin was found to have a high rate of clinical success, similar to that of other regimens (97% for azithromycin monotherapy, compared with 96% for azithromycin-metronidazole and 95% for a comparator regimen) [20]. Moreover, azithromycin provided excellent rates of eradication of C. trachomatis, N. gonorrhoeae, M. hominis, and anaerobes [20]. Complicating the interpretation of this study, however, was the combining of 2 different trials in the analyses. In 1 trial, 500 mg of azithromycin was administered intravenously on day 1, followed by 250 mg of oral azithromycin for 6 days. In the other trial, the intravenous protocol was conducted for 2 days, followed by oral azithromycin therapy for 5 days. The comparator regimens in each trial differed as well. Therefore, the optimal azithromycin regimen cannot be determined. Furthermore, the dropout rate at the final follow-up visit was extremely high (78%), and this reduces the validity and generalizability of the microbiological cure evaluation. Doxycycline and Metronidazole TrialsA few studies have further examined the outpatient combination regimen of doxycycline and metronidazole. In a randomized clinical trial of 40 patients with laparoscopically confirmed salpingitis, combined doxycycline-metronidazole treatment exhibited a low clinical cure rate of 35%, with a 50% clinical improvement rate [21]. The low efficacy of this regimen was replicated in an observational study in the United Kingdom involving 135 women with PID, in which only 55% experienced a clinical cure 2 or 4 weeks after treatment [26]. The addition of ceftriaxone to this regimen resulted in a higher but still suboptimal cure rate of 72% [26]. Because combined doxycycline-metronidazole provides poor coverage against N. gonorrhoeae and was also associated with the lowest pooled clinical and microbiological cure rates in the meta-analysis conducted by Walker et al. [14], this is not considered to be an optimal regimen for treatment of PID. Inpatient Meropenem TrialMost randomized clinical trials of monotherapy for PID have been conducted among women with mild to moderate PID who were treated as outpatients. In a study of 84 women hospitalized because of PID, meropenem, which has demonstrated in vitro activity against a broad spectrum of gram-negative and gram-positive aerobic and anaerobic bacteria, was found to be associated with high rates of clinical response and microbiological cure that were relatively similar to those found with treatment with clindamycin plus gentamicin (clinical response rate, 88% vs. 90%; microbiological cure rate, 88% vs. 86%) [22]. However, only 37% of patients had cultures performed after treatment and were included in comparisons of microbiological cure. Further studies are needed to confirm the use of this well-tolerated [22] broad-spectrum inpatient monotherapy regimen for the treatment of PID. DiscussionAmong the recent trials of treatment for PID, regimens including ofloxacin, moxifloxacin, azithromycin, and clindamycin-ciprofloxacin all yielded high rates of clinical cure and eradication of N. gonorrhoeae and C. trachomatis, although microbiological cure data among women with PID due to anaerobes are limited. This is attributable, in part, to the complexity of studying PID due to anaerobes, because the organisms may be present as commensal bacteria in the lower genital tract, and transcervical sampling of the endometrium may result in contamination of endometrial biopsy specimens by vaginal or cervical microorganisms. However, we have previously demonstrated that contamination likely does not account for the relationships between bacterial vaginosis–associated microorganisms and acute endometritis. In the PID Evaluation and Clinical Health (PEACH) study, we have shown that anaerobic gram-negative bacteria are associated with acute endometritis independent of bacterial vaginosis [9]. Furthermore, anaerobic gram-negative rods and anaerobic gram-positive cocci—but not other organisms frequent among women with bacterial vaginosis (e.g., Gardnerella vaginalis and M. hominis)—are associated with acute endometritis [9]. Another barrier to the study of microbiological cure of PID is the lack of 100% correlation between the microbiological makeup of the endometrium and fallopian tube and the unlikelihood of determining the microbiological flora of the fallopian tube after treatment. Despite the challenges facing the study of PID due to anaerobic organisms as a result of the fact that only one-third to one-half of PID cases are attributed to N. gonorrhoeae and/or C. trachomatis and the fact that bacterial vaginosis, anaerobic gram-negative rods, and mycoplasmal bacteria have been identified among women with PID [9, 10, 12, 27, 28], the microbiological efficacy of treatment regimens for both chlamydial and/or gonococcal and nonchlamydial and/or nongonococcal PID should be determined. Unfortunately, previous trials of metronidazole showed it to have limited efficacy, perhaps because poor tolerability limits adherence. Indeed, the highest rates of adverse effects and study discontinuation in the randomized clinical trials reviewed herein occurred in women who were assigned to comparator regimens containing metronidazole [18–20]. This fact underscores the need for research on agents for the treatment of PID that are bactericidal for anaerobes. Regimens with shorter duration and monotherapy regimens are promising and may increase compliance and decrease sequelae. However, there is currently limited evidence for the recommendation of alternative therapies for the treatment of anaerobic PID. Although azithromycin provides coverage against a range of anaerobic and aerobic pathogens (including black-pigmented gram-negative rods) [20, 29], fluoroquinolones, including ofloxacin, have generally been found to have limited activity against anaerobes [30, 31]. In a recent trial of moxifloxacin versus ofloxacin plus metronidazole, moxifloxacin was found to be as clinically efficacious as ofloxacin plus metronidazole and to exhibit similar cure rates for C. trachomatis and Mycoplasma and better cure rates for N. gonorrhoeae and gram-negative anaerobes [18]. However, women treated with moxifloxacin experienced a worse cure rate for gram-positive anaerobes [18]. Alternatively, a study has shown azithromycin to be effective for the treatment of anaerobic PID [20]. Clinical cure rates and eradication of anaerobes are similar among women whose PID is treated with azithromycin alone and women treated with combination azithromycin-metronidazole (clinical cure rate, 97% vs. 96%; anaerobe eradication rate, 100% vs. 100%) [20]. This initial study is promising, and further work may support the use of azithromycin monotherapy for the treatment of anaerobic PID. However, neither azithromycin nor quinolones are optimal for the treatment of gonococcal PID, because increasing drug resistance is being reported [32–36]. Treatment efficacy in the studies reviewed was restricted to short-term clinical and microbiological cure. There are limited data on the efficacy of any PID treatment regimen in the prevention of adverse reproductive sequelae. From the PEACH study, we have previously reported that, among women with clinically suspected mild to moderate PID treated with the standard antibiotic regimen of doxycycline and cefoxitin, endometritis and upper genital tract gonococcal and chlamydial infection were not associated with reproductive morbidity [37]. One interpretation is that these antibiotics that are used to treat modern-day mild to moderate chlamydial and gonococcal PID limited to the uterus are so effective that reproductive morbidity is not elevated among women with treated endometritis. However, despite the high rates of clinical cure and eradication of N. gonorrhoeae and C. trachomatis observed in the PEACH study at 30 days after treatment [38], rates of infertility (17%) [38], recurrent PID (14%) [38], and chronic pelvic pain (37%) [39] were distressingly elevated over the course of follow-up. This suggests a need to discover and provide coverage against all possible damaging PID pathogens and also to focus on long-term morbidity in treatment efficacy evaluations. It is possible that women with nongonococcal PID may be more likely to experience adverse sequelae. In the PEACH study, we reported that women with nongonococcal bacteria identified in the endometrium were generally more likely to experience reproductive morbidity than were women with gonococcal infection. Infertility rates were 13% for women with N. gonorrhoeae identified, 19% for women with C. trachomatis identified, 22% for women with anaerobic bacteria identified, 27% for women with U. urealyticum identified, and 17% for women with M. hominis identified; chronic pelvic pain rates were 27% for women with N. gonorrhoeae identified, 21% for women with C. trachomatis identified, 33% for women with anaerobic bacteria identified, 41% for women with U. urealyticum identified, and 54% for women with M. hominis identified. Similarly, in a study by Brunham et al. [40] of 50 women with laparoscopically confirmed salpingitis, 54% of women with nongonococcal infections had future adverse reproductive outcomes, compared with none of the women with gonococcal infections. Collectively, the PEACH study [37] and the study by Brunham et al. [40] suggest that, although these regimens may have high short-term clinical and microbiological cure rates, the standard antibiotic regimens of doxycycline-cefoxitin [37], doxycycline-clindamycin [40], and doxycycline-metronidazole [40] may not be optimal for the prevention of adverse sequelae among women with nongonococcal PID. Animal models may provide insight into better regimens for the treatment of nongonococcal PID. Rapid single-dose oral azithromycin therapy has been found to prevent infertility in a mouse model of chlamydial salpingitis [41]. Similarly, azithromycin was found to be more effective than doxycycline in the microbiological cure of C. trachomatis infection and the prevention of immunopathological upper reproductive tract damage in a macaque model of PID [42]. Studies of reproductive sequelae following various PID treatment regimens in humans are needed. In summary, a focus on reproductive and gynecologic morbidity, rather than on short-term clinical and microbiological cure, is greatly needed. Whether currently prescribed PID antibiotic regimens are effective in the prevention of subsequent reproductive morbidity is largely unknown. Arguably, long-term PID sequelae represent the most important treatment outcomes. Ultimately, microbe-specific and optimized treatment needs to preserve fertility following PID and also prevent recurrent and persistent infection, ectopic pregnancy, and chronic pain, improving the long-term prognosis for women who have PID. AcknowledgmentsPotential conflicts of interest. C.L.H. and R.B.N.: no conflicts. References1 , , , , . Pelvic inflammatory disease and fertility , Sex Transm Dis , 1992 , vol. 19 (pg. 185 - 92 ) 2 Division of STD Prevention, Centers for Disease Control and Prevention , Sex transmitted disease surveillance, 1997 , 1998 Atlanta Centers for Disease Control and Prevention 3 , . Cost and payment source for pelvic inflammatory disease: trends and projections, 1983 through 2000 , JAMA , 1991 , vol. 266 (pg. 2565 - 9 ) 4 , , , . Direct medical cost of pelvic inflammatory disease and its sequelae: decreasing, but still substantial , Obstet Gynecol , 2000 , vol. 95 (pg. 397 - 402 ) 5 . Decrease in incidence of women treated in hospital for acute salpingitis in Sweden , Genitourin Med , 1988 , vol. 64 (pg. 59 - 63 ) 6 , , , , , . The rate of diagnosis and demography of pelvic inflammatory disease in general practice: England and Wales , Int J STD AIDS , 1999 , vol. 10 (pg. 448 - 51 ) 7 , , , et al. Douching in relation to bacterial vaginosis, lactobacilli, and facultative bacteria in the vagina , Obstet Gynecol , 2002 , vol. 100 (pg. 765 - 72 )
8 , , , et al. Role of bacterial vaginosis-associated microorganisms in endometritis , Am J Obstet Gynecol , 1996 , vol. 175 (pg. 435 - 41 ) 9 , , , . Bacterial vaginosis and anaerobic bacteria are associated with endometritis , Clin Infect Dis , 2004 , vol. 39 (pg. 990 - 5 ) 10 , , , . Mycoplasma genitalium among women with nongonococcal, nonchlamydial pelvic inflammatory disease , Infect Dis Obstet Gynecol , 2006 pg. 28 Article ID 30.1155/IDOG/2006/30184 11 , , , et al. Associations between Mycoplasma genitalium, Chlamydia trachomatis, and pelvic inflammatory disease , J Clin Pathol , 2003 , vol. 56 (pg. 616 - 8 ) 12 , , , et al. Association between Mycoplasma genitalium and acute endometritis , Lancet , 2002 , vol. 359 (pg. 765 - 6 ) 13
Centers for Disease Control and Prevention Sexually transmitted diseases treatment guidelines , MMWR Morb Mortal Wkly Rep , 2006 , vol. 55 (pg. 56 - 60 ) 14 , , , , . Pelvic inflammatory disease: metaanalysis of antimicrobial regimen efficacy , J Infect Dis , 1993 , vol. 168 (pg. 969 - 78 ) 15 , , , et al. Medical and psychiatric symptoms in women with childhood sexual abuse , Psychosom Med , 1992 , vol. 54 (pg. 658 - 64 ) 16 , , , , , . Multicenter randomized trial of ofloxacin versus cefoxitin and doxycycline in outpatient treatment of pelvic inflammatory disease. Ambulatory PID Research Group , South Med J , 1993 , vol. 86 (pg. 604 - 10 ) 17 , , , et al. Oral clindamycin and ciprofloxacin versus intramuscular ceftriaxone and oral doxycycline in the treatment of mild-to-moderate pelvic inflammatory disease in outpatients , Clin Infect Dis , 1997 , vol. 24 (pg. 170 - 8 ) 18 , , , et al. Moxifloxacin versus ofloxacin plus metronidazole in uncomplicated pelvic inflammatory disease: results of a multicentre, double blind, randomised trial , Sex Transm Infect , 2006 , vol. 82 (pg. 446 - 51 ) 19 , , , , . Ciprofloxacin-tinidazole combination, fluconazole-azithromycin-secnidazole-kit and doxycycline-metronidazole combination therapy in syndromic management of pelvic inflammatory disease: a prospective randomized controlled trial , Indian J Med Sci , 2003 , vol. 57 (pg. 549 - 55 ) 20 , , . Efficacy and safety of azithromycin as monotherapy or combined with metronidazole compared with two standard multidrug regimens for the treatment of acute pelvic inflammatory disease , J Int Med Res , 2003 , vol. 31 (pg. 45 - 54 ) 21 , , , et al. A comparison of pefloxacin/metronidazole and doxycycline/metronidazole in the treatment of laparoscopically confirmed acute pelvic inflammatory disease , Eur J Obstet Gynecol Reprod Biol , 1993 , vol. 50 (pg. 153 - 8 ) 22 , , , , . A multicenter study comparing intravenous meropenem with clindamycin plus gentamicin for the treatment of acute gynecologic and obstetric pelvic infections in hospitalized women , Clin Infect Dis , 1997 , vol. 24 Suppl 2 (pg. 222 - 30 ) 23 , , . Microbial etiology of urban emergency department acute salpingitis: treatment with ofloxacin , Am J Obstet Gynecol , 1992 , vol. 167 (pg. 653 - 60 ) 24 , , , , . Evaluation of ofloxacin in the treatment of laparoscopically documented acute pelvic inflammatory disease (salpingitis) , Infect Dis Obstet Gynecol , 1999 , vol. 7 (pg. 138 - 44 ) 25 , , , . A randomized controlled trial of azithromycin versus doxycycline/ciprofloxacin for the syndromic management of sexually transmitted infections in a resource-poor setting , J Antimicrob Chemother , 2002 , vol. 49 (pg. 875 - 8 ) 26 , . Improvement in the clinical cure rate of outpatient management of pelvic inflammatory disease following a change in therapy , Sex Transm Infect , 2005 , vol. 81 (pg. 233 - 5 ) 27 , , , et al. Risk factors associated with pelvic inflammatory disease: a UK study , Int J STD AIDS , 2002 , vol. 13 pg. 18 28 , , , et al. Mycoplasma genitalium in the cervices of Japanese women , Sex Transm Dis , 1997 , vol. 24 (pg. 284 - 6 ) 29 , , , , . Activities of HMR 3004 (RU 64004) and HMR 3647 (RU 66647) compared to those of erythromycin, azithromycin, clarithromycin, roxithromycin, and eight other antimicrobial agents against unusual aerobic and anaerobic human and animal bite pathogens isolated from skin and soft tissue infections in humans , Antimicrob Agents Chemother , 1998 , vol. 42 (pg. 1127 - 32 ) 30 , . Is ciprofloxacin active against clinically important anaerobes? , J Antimicrob Chemother , 1986 , vol. 17 (pg. 605 - 13 ) 31 , , , , , . In-vitro and in-vivo potency of five new fluoroquinolones against anaerobic bacteria , J Antimicrob Chemother , 1986 , vol. 18 (pg. 693 - 701 ) 32 , , , , , . Mutations causing in vitro resistance to azithromycin in Neisseria gonorrhoeae , Int J Antimicrob Agents , 2003 , vol. 21 (pg. 414 - 9 ) 33 , , , et al. The emergence of Neisseria gonorrhoeae with decreased susceptibility to Azithromycin in Kansas City, Missouri, 1999 to 2000 , Sex Transm Dis , 2004 , vol. 31 (pg. 73 - 8 ) 34 , , , et al. Reduced susceptibility to azithromycin and high percentages of penicillin and tetracycline resistance in Neisseria gonorrhoeae isolates from Manaus, Brazil, 1998 , Sex Transm Dis , 2001 , vol. 28 (pg. 521 - 6 ) 35 , , , et al. Ciprofloxacin resistance in Neisseria gonorrhoeae in England and Wales in 2002 , Lancet , 2003 , vol. 361 (pg. 1867 - 9 ) 36 , , , et al. Evolution in the trends of antimicrobial resistance in Neisseria gonorrhoeae isolated in Durban over a 5 year period: impact of the introduction of syndromic management , J Antimicrob Chemother , 2001 , vol. 48 (pg. 853 - 9 ) 37 , , , et al. Endometritis does not predict reproductive morbidity following pelvic inflammatory disease , Am J Obstet Gynecol , 2003 , vol. 188 (pg. 141 - 8 ) 38 , , , et al. Effectiveness of inpatient and outpatient treatment strategies for women with pelvic inflammatory disease: results from the PID Evaluation and Clinical Health (PEACH) randomized trial , Am J Obstet Gynecol , 2002 , vol. 186 (pg. 929 - 37 ) 39 , , . Lower quality of life among women with chronic pelvic pain following pelvic inflammatory disease , Obstet Gynecol , 2003 , vol. 102 (pg. 934 - 9 ) 40 , , , et al. Etiology and outcome of acute pelvic inflammatory disease , J Infect Dis , 1988 , vol. 158 (pg. 510 - 7 ) 41 , , , . The effect of a single oral dose of azithromycin on chlamydial infertility and oviduct ultrastructure in mice , J Antimicrob Chemother , 1994 , vol. 34 (pg. 989 - 99 ) 42 , , . Significant reduction in inflammatory response in the macaque model of chlamydial pelvic inflammatory disease with azithromycin treatment , J Infect Dis , 2005 , vol. 192 (pg. 129 - 35 ) Figures and TablesTable 2 Randomized clinical trials since 1992 for the treatment of pelvic inflammatory disease. © 2007 Infectious Diseases Society of America © 2007 Infectious Diseases Society of America Topic:
I agree to the terms and conditions. You must accept the terms and conditions. Submit a comment Name Affiliations Comment title Comment You have entered an invalid code Thank you for submitting a comment on this article. Your comment will be reviewed and published at the journal's discretion. Please check for further notifications by email. CitationsViewsAltmetricEmail alertsRelated articles in PubMedCiting articles via
More from Oxford Academic What is the best drug for treating pelvic inflammatory disease?Guidelines of the Centers for Disease Control and Prevention recommend outpatient treatment of PID with ofloxacin, levofloxacin, ceftriaxone plus doxycycline, or cefoxitin and probenecid plus doxycycline, all with optional metronidazole for full coverage against anaerobes and bacterial vaginosis (table 1) [13].
Can pelvic inflammatory disease be cured?Can PID be cured? Yes, if PID is diagnosed early, it can be treated. However, treatment won't undo any damage that has already happened to your reproductive system. The longer you wait to get treated, the more likely it is that you will have complications from PID.
Can PID be treated without surgery?If it's diagnosed at an early stage, pelvic inflammatory disease (PID) can be treated easily and effectively with antibiotics. These can be prescribed by your GP or a doctor at a sexual health clinic. But left untreated, it can lead to more serious long-term complications.
How do you get rid of pelvic inflammatory pain?PID is usually treated with antibiotic medicine. Mild PID without fever or severe pain is usually treated with a combination of antibiotic shots and oral antibiotics (pills). A more serious infection may be treated with several days of intravenous (IV) antibiotics given once or twice a day.
|
What is the best treatment for pelvic inflammatory disease
Related Posts
Copyright © 2024 ihoctot Inc.
