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Pelvic inflammatory disease: review of treatment options

H B Peterson1, E I Galaid, J M Zenilman

  • 1U.S. Department of Health and Human Services, Atlanta, Georgia.

Reviews of Infectious Diseases
|July 1, 1990
PubMed

Insights

Treatment guidelines for pelvic inflammatory disease (PID) are evolving due to incomplete understanding and antibiotic resistance. Current recommendations favor broad-spectrum antibiotic therapy for both inpatient and ambulatory cases.

Area of Science:

  • Infectious Diseases
  • Gynecology
  • Microbiology

Background:

  • Pelvic inflammatory disease (PID) treatment decisions are complex due to incomplete understanding of the syndrome.
  • Limited data on laparoscopic diagnosis and cure of PID hinder interpretation of therapy outcomes.
  • Increasing resistance of Neisseria gonorrhoeae to penicillin impacts treatment strategies.

Purpose of the Study:

  • To review and update antibiotic therapy recommendations for pelvic inflammatory disease (PID).
  • To evaluate the effectiveness of current and newer treatment regimens based on available data.
  • To address challenges in PID management, including diagnostic limitations and evolving microbial resistance.

Main Methods:

  • Review of validation studies for recommended antibiotic regimens.
  • Analysis of data from the 1985 and 1989 Centers for Disease Control (CDC) sexually transmitted diseases (STDs) treatment guidelines.
  • Assessment of clinical cure rates for cefoxitin/doxycycline and clindamycin/aminoglycoside regimens.

Main Results:

  • Cefoxitin/doxycycline and clindamycin/aminoglycoside regimens show consistently high clinical cure rates for PID.
  • Empiric, broad-spectrum antibiotic therapy remains the preferred treatment approach.
  • 1989 inpatient therapy recommendations are similar to 1985, but ambulatory management recommendations have changed significantly.

Conclusions:

  • Current antibiotic regimens demonstrate high efficacy in treating pelvic inflammatory disease (PID).
  • Empiric broad-spectrum therapy is crucial for effective PID management.
  • Adjustments in ambulatory PID treatment are necessary due to Neisseria gonorrhoeae penicillin resistance.

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