Evaluation of Tetracycline or Penicillin and Ampicillin for Treatment of Acute Pelvic Inflammatory Disease

Concerns Regarding the Centers for Disease Control's Published Guidelines for Pelvic Inflammatory Disease

“…Cunningham et al [14] demonstrated an 86% response rate within 3 days when the gonococcus was present at the endocervix, in contrast to a 74% response rate when it was absent. Thompson et al [15] reported a change of severity score by the fourth day in 73% of patients in whom the gonococcus was present at the endocervix, but only in 45% of patients in whom it was not.…”

“…However, if the gonococcus was a constituent of a polymicrobial peritonitis, the therapeutic response was often altered, unless most of the organisms present were susceptible to the antibiotic regimen that was administered. Longterm follow-up showed that patients who had significantly altered therapeutic responses had a significantly higher incidence of secondary fertility than patients who had prompt responses [12][13][14]. When the anaerobic progression resulted in autoelimination of the gonococcus within the cul-de-sac, it was difficult to achieve a good therapeutic response with antibiotics whose primary spectrum of efficacy focused on N. gonorrhoeae and C. trachomatis.…”

“…What may be excellent therapy for early gonococcal disease might guarantee unwanted future infertility or increased potential for ectopic pregnancies if used as therapy for disease at the wrong stage (Ortho-McNeil Pharmaceutical, personal communication) [11,14]. Therapeutic requisites for a tubo-ovarian complex or tubo-ovarian abscess are distinctly different from those for early monoetiological gonococcal disease.…”

The Role of Beta-Lactamase-Producing Bacteria in Obstetrical and Gynecological Infections

“…Treatment failure has been noticed in as many as 33% of patients [43] and increased frequency of abscess formation has been observed [44]. A recent review stated that therapy with penicillin either alone or with an aminoglycoside or tetracycline failed in 15-25% of cases [45].…”

1200 mg Rifampicin (Rimactan^®) als Einzeldosisbehandlung der unkomplizierten Gonorrhoe der Frau

“…Penizillin wird deshalb mehrfach ver abreicht oder mit Probenecid kombiniert [3][4][5][6], 1976 wurden fast gleichzeitig in England und Amerika erstmals betalaktamasebildende Stämme von N. gonorrhoeae isoliert. Die seit langem vorausgesehene und befürchtete Penizillinresistenz des Erregers der Gonor rhö war Tatsache geworden [7][8][9] Rifampicin (Rimactan®) hat eine bekann te Aktivität gegen N. gonorrhoeae in vitro [16] und hemmt intrazelluläre Bakterien [17] .…”