Clinical Predictors of Failed Medical Treatment in Patients with Tubo-ovarian Abscess: External Validation of a Recently Published Risk Score

Jalloul, Randa J.; Thomas, M. R.; Ward, Clara; Pedroza, Claudia

doi:10.1016/j.jmig.2022.01.004

Cited by 3 publications

(5 citation statements)

References 26 publications

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“…The 47% concomitant gynecological malignancy risk in postmenopausal women with TOA may lead the clinicians to decide favors surgical therapy. 34 Antibiotic therapy failure was defined as no clinical improvement after 48-72 h of medical therapy in most of the studies [5][6][7][8][9][10][11]13,14,[16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] included in the meta-analysis. The findings of the previous reports and this meta-analysis suggest that surgical intervention should not be delayed more than 48 h in women with identified risk factors.…”

Section: Discussionmentioning

confidence: 99%

“…Antibiotic therapy failure was defined as no clinical improvement after 48–72 h of medical therapy in most of the studies 5–11,13,14,16–32 included in the meta‐analysis. The findings of the previous reports and this meta‐analysis suggest that surgical intervention should not be delayed more than 48 h in women with identified risk factors.…”

Section: Discussionmentioning

confidence: 99%

“…Study characteristics presented in Table 1 were extracted by four authors independently 4–32 . The fifth author reviewed the extracted data.…”

Section: Methodsmentioning

confidence: 99%

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Risk factors for antibiotic therapy failure in women with tubo‐ovarian abscess: A systematic review and meta‐analysis

Kinay,

Akay,

Aksoy

et al. 2024

J of Obstet and Gynaecol

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AimMedical therapy with antibiotics only and surgical drainage are the treatment options of tubo‐ovarian abscess (TOA). It is not yet known exactly which cases need surgical treatment. The aim of this systematic review and meta‐analysis was to evaluate the risk factors leading antibiotic therapy failure in women with TOA.MethodsWe searched the following databases from inception to June 1, 2022: PubMed, Ovid MEDLINE, The Cochrane Library, and Scopus. We also searched reference lists of eligible articles and related review articles. The observational cohort, cross‐sectional, and case–control studies were included in the meta‐analysis. At least four review authors independently selected eligible articles, assessed risk of bias, and extracted data. The random effect model was used in the meta‐analysis.ResultsA total of 29 studies, including 2890 women, were included in the study. The age, abscess size, history of intrauterine device use, postmenopausal status, history of diabetes mellitus, fever, white blood cell count, erythrocyte sedimentation rate, C‐reactive protein level, and history of pelvic inflammatory disease were found as significant risk factors for antibiotic therapy failure in women with TOA.ConclusionsThe findings of this study clarified the risk factors for antibiotic therapy failure in women with TOA.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Risk factors for antibiotic therapy failure in women with tubo‐ovarian abscess: A systematic review and meta‐analysis

Kinay,

Akay,

Aksoy

et al. 2024

J of Obstet and Gynaecol

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“…Jalloul et al [14 ▪ ] recently published an observational retrospective cohort study (169 patients) presenting with pelvic abscess, externally validating the simple clinical risk score proposed by Fouks et al [15], which predicts who will likely fail to respond to medical treatment. Four clinical predictors at time of presentation are assessed: age (>36 years of age), white blood cell count (>16 x 1000/μl), pelvic abscess size (>70 mm) and presence of bilateral pelvic abscess.…”

Section: Body Of Reviewmentioning

confidence: 99%

Pelvic abscess – to drain or not to drain?

Strong,

Lazanakis,

Ball

2023

Current Opinion in Obstetrics &Amp; Gynecology

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Purpose of reviewPelvic abscess is a common gynaecological condition, particularly during and after the Covid-19 pandemic, possibly resulting from obstacles to accessing care during this time. To date, no consensus guideline on management exists with a lack of applicable randomized controlled trials (RCTs) comparing medical management with antibiotics alone, image-guided drainage and surgical management, despite this being a potentially life-threatening condition. Recent findingsWe present the current literature assessing risks, which contribute to failure of medical therapy, predictive models to guide management and reports of long-term sequelae. Consideration for early laparoscopic or image-guided drainage should be given to women in whom fertility is a priority, pelvic abscess at least 7 cm, white blood cell count on admission more than 16 x 1000/ml, bilateral pelvic abscess, intrauterine device in situ for more than 5.5 years and preexisting endometrioma. Pelvic abscess rupture or severe sepsis should always trigger timely drainage.

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“…The recurrence rate of TOA is reported to be higher when patients are only treated with antibiotics [9,10]. The factors affecting the success of medical treatment are the patient's age, the size of the abscess, elevated white blood cell (WBC) count, body mass index and C-reactive protein (CRP) values [11,12].…”

Section: Introductionmentioning

confidence: 99%

Which treatment should we choose for tubo-ovarian abscesses? Results of an 8-year clinical training in a tertiary center

Bestel,

Günkaya,

Aldıkactioglu Talmac

et al. 2023

Ginekol Pol

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Objectives: Tubo-ovarian abscess (TOA) is inflammation of the pelvic organs, mainly originating from the lower genital tract and intestinal tract. Treatment options include antibiotic therapy, surgical drainage, and radiologically guided (interventional) drainage. In our study, we aimed to evaluate the treatment method to be chosen and thus to manage patients with tuba ovarian abscesses (TOAs) most accurately. Material and methods:This is a retrospective cohort study, and patients who applied to a tertiary center diagnosed with tuba ovarian abscess (TOA) were included. TOA size (cm), pre-treatment C-reactive protein (CRP) value, pre-treatment white blood cell (WBC) value, previous operation type, postoperative complication, and antibiotics used were screened.Results: 305 patients were included in the study, and medical treatment was applied to 140 patients, organ-sparing surgical drainage to 50 patients, and surgical treatment to 115 patients. TOA dimensions measured at the time of diagnosis were significantly lower in patients for whom only medical treatment was sufficient. Pre-treatment CRP levels, WBC levels, and length of stay were significantly lower in patients for whom only medical treatment was sufficient. There was no significant difference between the pre-and post-procedure CRP difference, antibiotics, and hospitalization time. Conclusions:Preferring minimally invasive treatment in cases requiring invasive treatment reduces the frequency of complications. Treatment of tuba ovarian abscesses (TOA) with minimally invasive methods will be more beneficial in terms of patient morbidity.

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Clinical Predictors of Failed Medical Treatment in Patients with Tubo-ovarian Abscess: External Validation of a Recently Published Risk Score

Cited by 3 publications

References 26 publications

Risk factors for antibiotic therapy failure in women with tubo‐ovarian abscess: A systematic review and meta‐analysis

Risk factors for antibiotic therapy failure in women with tubo‐ovarian abscess: A systematic review and meta‐analysis

Pelvic abscess – to drain or not to drain?

Which treatment should we choose for tubo-ovarian abscesses? Results of an 8-year clinical training in a tertiary center

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