Pelvic inflammatory disease. Key treatment issues and options

Area of Science:

• Infectious Diseases
• Gynecology
• Pharmacology

Background:

• Pelvic inflammatory disease (PID) is a polymicrobial infection requiring effective antimicrobial treatment.
• Optimal therapeutic strategies are crucial for managing PID and preventing sequelae.

Purpose of the Study:

• To review current data on optimal antimicrobial therapy for pelvic inflammatory disease (PID).
• To address key treatment considerations for clinicians managing PID.

Main Methods:

• Systematic review of studies published since 1985, including those informing the 1989 CDC Sexually Transmitted Diseases Treatment Guidelines.
• MEDLINE search using terms related to PID and treatment, supplemented by bibliography reviews.
• Inclusion criteria focused on studies evaluating antimicrobial regimen effectiveness for PID treatment.

Main Results:

• Broad-spectrum combination antimicrobial regimens demonstrate high efficacy for clinical and microbiologic cure in PID.
• Effective treatment is achievable even in cases involving tubo-ovarian abscesses.
• Limited data exist regarding the optimal therapy for preventing long-term sequelae of PID.

Conclusions:

• No single antimicrobial agent provides adequate coverage for all causative pathogens of PID.
• Combination regimens are clinically effective, but uncertainties remain regarding prevention of late sequelae.
• Hospitalization should be considered for PID patients, especially those desiring future fertility, and all sex partners require treatment.