Comparing ceftriaxone plus azithromycin or doxycycline for pelvic inflammatory disease: a randomized controlled trial

Area of Science:

• Infectious Diseases
• Pharmacology
• Women's Health

Background:

• Pelvic inflammatory disease (PID) is a significant cause of female reproductive morbidity.
• Standard treatment regimens for mild PID often involve combination antibiotic therapy.

Purpose of the Study:

• To compare the efficacy of ceftriaxone combined with azithromycin versus ceftriaxone combined with doxycycline for treating mild pelvic inflammatory disease (PID).

Main Methods:

• Patients with mild PID received intramuscular ceftriaxone.
• Participants were randomized to receive either oral doxycycline for 14 days or oral azithromycin for 2 weeks.
• Pain and clinical cure rates were assessed at specified intervals.

Main Results:

• No significant difference in pain reduction was observed between the two treatment groups.
• Clinical cure rates were higher with azithromycin (98.2% per protocol, 90.3% intention-to-treat) compared to doxycycline (85.7% per protocol, 72.4% intention-to-treat).
• Azithromycin demonstrated a statistically significant benefit in achieving clinical cure for mild PID.

Conclusions:

• Ceftriaxone plus a 2-week course of azithromycin is an effective treatment for mild PID.
• The azithromycin regimen offers a comparable or superior clinical cure rate to the doxycycline regimen when used with ceftriaxone.
• This study supports azithromycin as a viable option in the management of mild pelvic inflammatory disease.