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Treatment of Acute Pelvic Inflammatory Disease

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Pelvic Inflammatory Disease

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Abstract

The optimum strategy for minimizing the sequelae is prevention of pelvic inflammatory disease (PID) by preventing lower genital tract infections such as cervicitis with Neisseria gonorrhoeae or Chlamydia trachomatis and bacterial vaginosis (BV) (i.e., primary prevention).1 A secondary approach, when primary prevention fails, relies on early detection and prompt treatment of lower genital tract infections. Unfortunately accomplishing either of these two strategies requires effective sexually transmitted disease (STD) control programs, which to date are sorely lacking in the United States. Thus, in the United States prevention of these sequelae relies on prompt diagnosis and treatment of acute PID. This so-called tertiary prevention approach is further complicated by the wide spectrum of clinical presentation of PID, ranging from asymptomatic (“silent”) to minimally symptomatic (“atypical” or “unrecognized”) to clinical PID (“typical”). Whether patients are truly asymptomatic or unrecognized because they present with minimal or atypical signs and symptoms of PID has been uncertain. Recently, Wølner-Hanssen2 provided data demonstrating that patients listed as having silent PID truly did have symptoms suggestive of PID when questioned extensively.

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References

  1. Centers for Disease Control. Pelvic inflammatory disease: Guidelines for prevention and management. MMWR 1991;40:1–25.

    Google Scholar 

  2. Wølner-Hanssen P. Silent pelvic inflammatory disease: Is it overstated? Obstet Gynecol 1995;86:321–325.

    Article  PubMed  Google Scholar 

  3. Viberg L. Acute inflammatory conditions of the uterine adnexa. Acta Obstet Gynecol Scand 1964;43(S4):5.

    Article  Google Scholar 

  4. Swenson CE, Donegan E, Schachter J. Chlamydia trachomatis induced salpingitis in mice. J Infect Dis1983;148:1101–1107.

    Article  PubMed  CAS  Google Scholar 

  5. Swenson CE, Schachter J. Infertility as a consequence of chlamydial infection of the upper genital tract in female mice. Sex Transm Dis 1984;11:64–67.

    Article  PubMed  CAS  Google Scholar 

  6. Centers for Disease Control. 1993 Sexually transmitted disease. Treatment guidelines. MMWR 1993;42:1–102.

    Google Scholar 

  7. Eschenbach DA, Buchanan T, Pollock HM, et al. Polymicrobial etiology of acute pelvic inflammatory disease. N Engl J Med 1975;293:166.

    Article  PubMed  CAS  Google Scholar 

  8. Eschenbach DA, Hillier S, Critchlow C, et al. Diagnosis and clinical manifestations of bacterial vaginosis. Am J Obstet Gynecol 1988;158:819–828.

    PubMed  CAS  Google Scholar 

  9. Rice PA, Schachter J. Pathogenesis of pelvic inflammatory disease caused by Chlamydia trachomatis and Neisseria gonorrhoeae: Where should research efforts focus? in Joint Meeting of the Centers for Disease Control and National Institutes of Health about Pelvic Inflammatory Disease Prevention, Management, and Research in the 1990’s, Bethesda, Maryland, September 4-5, 1990.

    Google Scholar 

  10. Paavonen J, Teisala K, Heinonnen PK, et al. Microbiological and histopathological findings in acute pelvic inflammatory disease. Br J Obstet Gynecol 1987;94:454–460.

    Article  CAS  Google Scholar 

  11. Hillier SL, Kiviat NB, Critchlow C, et al. Bacterial vaginosis-associated bacteria as etiologic agents of pelvic inflammatory disease (abstract). Proceedings of the annual meeting Infectious Disease Society of Obstetrics and Gynecology. San Diego, CA, August 6, 1992.

    Google Scholar 

  12. Sweet RL. Role of bacterial vaginosis in pelvic inflammatory disease. Clin Infect Dis 1995;20(suppl 2).

    Google Scholar 

  13. Glatt AE, McCormack WM, Taylor Robinson D. Genital mycoplasmas, in Holmes KK, Mardh P-A, Sparling PF, Wiesner PJ (eds): Sexually Transmitted Diseases, 2nd ed. New York, McGraw-Hill Information Services, 1990, pp 279–293.

    Google Scholar 

  14. Rice PA, Schachter J. Pathogeneis of pelvic inflammatory disease. JAMA 1991;266:2587–2593.

    Article  PubMed  CAS  Google Scholar 

  15. Jossens MOR, Schachter J, Sweet RL. Risk factors associated with pelvic inflammatory disease of differing microbial etiologies. Obstet Gynecol 1994;83:989–997.

    Article  PubMed  CAS  Google Scholar 

  16. Sweet RL. Diagnosis and treatment of acute salpingitis. J Reprod Med 1977;19:21.

    PubMed  CAS  Google Scholar 

  17. Platt R, Rice PA, McCormack WM. Risk of acquiring gonorrhea and prevalence of abnormal adnexal findings among women recently exposed to gonorrhea. JAMA 1983;250:3205–3209.

    Article  PubMed  CAS  Google Scholar 

  18. Stamm WE, Guinan ME, Johnson C, et al. Effect of treatment regimens for Neisseria gonorrhoeae on simultaneous infection with Chlamydia trachomatis. N Engl J Med 1984;310:545–549.

    Article  PubMed  CAS  Google Scholar 

  19. Holtz F. Klinische Studien uber die nicht tuberjulose salpingoophoritis. Acta Obstet Gynecol 1930;10(S):5.

    Article  Google Scholar 

  20. Curtis AH. Bacteriology and pathology of fallopian tubes removed at operation. Surg Gynecol Obstet 1921;33:621.

    Google Scholar 

  21. Andrews FT. Notes on causes of salpingitis. Am J Obstet Gynecol 1940; 49:177.

    Google Scholar 

  22. Curtis AH. Obstetrics and Gynecology, vol 2. Philadelphia, WB Saunders, 1933, p497.

    Google Scholar 

  23. Falk V. Treatment of acute nontuberculous salpingitis with antibiotics along and in combination with glucocorticoids. Acta Obstet Gynecol Scand 1965; 44(S-16):65.

    Google Scholar 

  24. Hedberg E, Anberg A. Gonorrheal salpingitis: Views on treatment and prognosis. Fertil Steril 1965;16:125.

    PubMed  CAS  Google Scholar 

  25. Falk V, Krook G. Do results of culture of gonococci vary with sampling phase of menstrual cycle? Ada Derm Venereol (Stockh) 1967;47:190.

    CAS  Google Scholar 

  26. Weström LV, Berger GS. Consequences of pelvic inflammatory disease, in Berger GS, Weström LV (eds): Pelvic Inflammatory Disease. New York, Raven Press, 1992, pp 101–114.

    Google Scholar 

  27. Hubscher K. Uber die haufgkeit von konzeptionen nach knoservierend und konservativer behandlung von adnexentzundungen. Zentralbl Gynakol 1933; 57:2061–2065.

    Google Scholar 

  28. Haffner JC. Resultatene av den konservative og operative salpingitt-behandling. Nord Med 1939;3:2255–2260.

    Google Scholar 

  29. Hedberg E, Spetz SO. Acute salpingitis. Views on prognosis and treatment. Acta Obstet Gynecol Scand 1958;37:131–135.

    Article  PubMed  CAS  Google Scholar 

  30. Weström LV. Incidence, prevalence, and trends of acute pelvic inflammatory disease and its consequences in industrialized countries. Am J Obstet Gynecol 1980;138:880.

    PubMed  Google Scholar 

  31. Weström LV. Reproductive events after acute salpingitis. Br J Clin Pract 1982;17(suppl):17–20.

    Google Scholar 

  32. Brunham RC, Binns B, Guijon F, et al. Etiology and outcome of acute pelvic inflammatory disease. J Infect Dis 1988;158:510–517.

    Article  PubMed  CAS  Google Scholar 

  33. Safrin S, Schachter J, Dahrouge D, Sweet R. Long-term sequelae of acute pelvic inflammatory disease. Am J Obstet Gynecol 1992;166:1300–1305.

    PubMed  CAS  Google Scholar 

  34. Brunham RC, Binns B, Guijon F, et al. Etiology and outcome of acute pelvic inflammatory disease. J Infect Dis 1988;158:510–517.

    Article  PubMed  CAS  Google Scholar 

  35. Weström LV, Joesoef R, Reynolds G, et al. Pelvic inflammatory disease and fertility. A cohort study of 1,844 women with laparoscopically verified disease and 657 control women with normal laparoscopic results. Sex Transm Dis 1992;19:185–192.

    Article  PubMed  Google Scholar 

  36. Weström L. Effect of acute pelvic inflammatory disease on fertility. Am J Obstet Gynecol 1975;122:876.

    Google Scholar 

  37. Weström L, Iosif S, Svensson L, et al. Infertility after antibiotics. Curr Ther 1979;26:752–759.

    Google Scholar 

  38. Svensson L, Mardh P-A, Weström L. Infertility after acute salpingitis with special reference to Chlamydia trachomatis. Fertil Steril 1983;40:322–329.

    PubMed  CAS  Google Scholar 

  39. Hillis SD, Joesoef R, Marchbanks PA, Wasserheit JN, Willard C, Weström L. Delayed care of pelvic inflammatory disease as a risk factor for impaired fertility. Am J Obstet Gynecol 1993;168:1503–1509.

    PubMed  CAS  Google Scholar 

  40. Katz BP, Zwickl BW, Caine VA, Jones RB. Compliance with antibiotic therapy for Chlamydia trachomatis and Neisseria gonorrhoeae. Sex Trans Dis 1992; 19:351–354.

    Google Scholar 

  41. Sweet RL, Schachter J, Landers DV, et al. Treatment of hospitalized patients with acute pelvic inflammatory disease. Comparison of cefotetan plus doxycy-cline and cefoxotin plus doxycycline. Am J Obstet Gynecol 1988;158:736–743.

    PubMed  CAS  Google Scholar 

  42. Mourod A, Sweet RL, Sugg N, Schachter J. Relative resistance to erythromycin in Chlamydia trachomatis. Antimicrob Agents Chemother 1980;18:696–698.

    Article  Google Scholar 

  43. Wasserheit JN, Bell TA, Kiviat NB, et al. Microbial causes of proven pelvic inflammatory disease and efficacy of clindamycin and tobramycin. Ann Intern Med 1986;104:187–193.

    PubMed  CAS  Google Scholar 

  44. Sweet RL, Schachter J. Ohm-Smith M, et al. Treatment of acute PID: Cefoxitin plus doxycycline versus clindamycin plus tobramycin. Abstract, in 25th Interscience and Conference Antimicrobial Agents Chemotherapy. Minneapolis, September 29-October 2, 1983.

    Google Scholar 

  45. Draper DL, James JF, Hadley WK, Sweet RL. Auxotypes and antibiotic susceptibilities of Neisseria gonorrhoeae from women with acute salpingitis. Comparison with gonococci causing uncomplicated genital tract infections in women. Sex Transm Dis 1981;8:43.

    Article  PubMed  CAS  Google Scholar 

  46. Reed SD, Landers DV, Sweet RL. Antibiotic treatment of tubo-ovarian abscess: Comparison of broad spectrum betalactam agents versus clindamycin containing regimens. Am J Obstet Gynecol 1991;164:1556–1562.

    PubMed  CAS  Google Scholar 

  47. Walker CK, Kahn JG, Washington AE, Peterson HB, Sweet RL. Pelvic inflammatory disease. Meta-analysis of antimicrobial regimen efficacy. J Infect Dis 1993;168:969–978.

    Article  PubMed  CAS  Google Scholar 

  48. Dodson MG. Antibiotic regimens for treating acute pelvic inflammatory disease: An evaluation. J Reprod Med 1994;39:285–296.

    PubMed  CAS  Google Scholar 

  49. Schwarcz SK, Zenilman JM, Schnell D, et al. National surveillance of antimicrobial resistance in Neisseria gonorrhoeae. JAMA 1990;264:1213–1216.

    Article  Google Scholar 

  50. Eschenbach DA. A review of beta-lactamase producing bacteria in obstetric-gynecologic infection. Am J Obstet Gynecol 1987;156:495–498.

    PubMed  CAS  Google Scholar 

  51. Hasselquist MB, Hillier S. Susceptibility of upper-genital tract isolates from women with pelvic inflammatory disease to ampicillin, cefpodoxime, metronidazole, and doxycycline. Sex Transm Dis 1991;18:146–149.

    PubMed  CAS  Google Scholar 

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Authors
  1. Richard L. Sweet
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Editors and Affiliations

  1. Division of Reproductive Infectious Diseases and Immunology, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, Magee-Women’s Hospital, Pittsburgh, PA, 15213-3180, USA

    Daniel V. Landers M.D. (Associate Professor and Director) (Associate Professor and Director)

  2. Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, Magee-Women’s Hospital, Pittsburgh, PA, 15213-3180, USA

    Richard L. Sweet M.D. (Professor and Chairman) (Professor and Chairman)

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© 1997 Springer Science+Business Media New York

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Sweet, R.L. (1997). Treatment of Acute Pelvic Inflammatory Disease. In: Landers, D.V., Sweet, R.L. (eds) Pelvic Inflammatory Disease. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-0671-2_5

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  • DOI: https://doi.org/10.1007/978-1-4612-0671-2_5

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4612-6863-5

  • Online ISBN: 978-1-4612-0671-2

  • eBook Packages: Springer Book Archive

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