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2017 European guideline for the management of pelvic inflammatory disease
Jonathan Ross1, Secondo Guaschino2, Marco Cusini3
11 University Hospital Birmingham NHS Foundation Trust, Birmingham, UK.
Abstract:
The European guideline for the management of pelvic inflammatory disease includes evidence-based advice on the investigation and treatment of pelvic inflammatory disease (PID). It has been updated to acknowledge the role of Mycoplasma genitalium as an important cause of PID with testing now recommended for women presenting with possible PID and for the male partners of women with confirmed M. genitalium infection. Recent evidence suggests that serious adverse events are uncommon when using moxifloxacin and its use is now recommended as a first-line therapy, especially in those women with M. genitalium PID. The potential utility of MRI scanning of the pelvis in excluding differential diagnoses has been highlighted. The use of doxycycline is now suggested as empirical treatment for male partners of women with PID to reduce exposure to macrolide antibiotics, which has been associated with increased resistance in M. genitalium.
Insights
The updated European guideline for pelvic inflammatory disease (PID) management now recommends Mycoplasma genitalium testing and moxifloxacin as a first-line therapy. Doxycycline is advised for male partners to combat antibiotic resistance.
Area of Science:
- Gynecology
- Infectious Diseases
- Public Health
Background:
- Pelvic inflammatory disease (PID) is a significant gynecological infection.
- Current management guidelines require updates to reflect emerging evidence.
Purpose of the Study:
- To present the updated European guideline for PID management.
- To incorporate new evidence on Mycoplasma genitalium and treatment strategies.
Main Methods:
- Evidence-based review and synthesis of recent research.
- Expert consensus on diagnostic and therapeutic recommendations.
Main Results:
- Mycoplasma genitalium identified as a key cause of PID, necessitating targeted testing.
- Moxifloxacin recommended as first-line treatment, particularly for M. genitalium PID.
- MRI scanning suggested for differential diagnosis exclusion.
- Doxycycline recommended for male partners to mitigate macrolide resistance.
Conclusions:
- Updated guidelines provide evidence-based strategies for PID investigation and treatment.
- Focus on M. genitalium and appropriate antibiotic selection is crucial for effective management and resistance prevention.
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