Oral Clindamycin and Ciprofloxacin Versus Intramuscular Ceftriaxone and Oral Doxycycline in the Treatment of Mild-to-Moderate Pelvic Inflammatory Disease in Outpatients

Arredondo, José Luis; Díaz, Víctor; Gaitán, Hernando; Maradiegue, Eduardo; Oyarzún, E; Paz, Raquel de; Reynal, Jose L.; Stamm, W; Zambrano, David

doi:10.1093/clinids/24.2.170

Cited by 51 publications

(25 citation statements)

References 22 publications

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“…(c) Cultures positive for Neisseria gonorrhoeae or Chlamydia trachomatis in the cervix or endometrium, or by the presence of aerobic or anaerobic bacteria, N. gonorrhoeae, mycoplasma or ureaplasma in the endometrium 13,19 .…”

Section: Methodsmentioning

confidence: 99%

Accuracy of Five Different Diagnostic Techniques inMild‐to‐Moderate Pelvic Inflammatory Disease

Gaitán

Ángel

Díaz

et al. 2002

Infectious Diseases in Obstetrics and Gynecology

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Objective: To evaluate the clinical diagnosis of pelvic inflammatory disease (PID) compared with the diagnosis of PID made by laparoscopy, endometrial biopsy, transvaginal ultrasound, and cervical and endometrial cultures. Study design: A diagnostic performance test study was carried out by cross-sectional analysis in 61 women. A group presenting PID (n = 31) was compared with a group (n = 30) presenting another cause for non-specific lower abdominal pain (NSLAP). Diagnosis provided by an evaluated method was compared with a standard diagnosis (by surgical findings, histopathology, and microbiology). The pathologist was unaware of the visual findings and presumptive diagnoses given by other methods. Results: All clinical and laboratory PID criteria showed low discrimination capacity. Adnexal tenderness showed the greatest sensitivity. Clinical diagnosis had 87% sensitivity, while laparoscopy had 81% sensitivity and 100% specificity; transvaginal ultrasound had 30% sensitivity and 67% specificity; and endometrial culture had 83% sensitivity and 26% specificity. Conclusions: Clinical criteria represent the best diagnostic method for discriminating PID. Laparoscopy showed the best specificity and is thus useful in those cases having an atypical clinical course for discarding abdominal pain when caused by another factor. The other diagnostic methods might have limited use.

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Section: Methodsmentioning

confidence: 99%

Accuracy of Five Different Diagnostic Techniques inMild‐to‐Moderate Pelvic Inflammatory Disease

Gaitán

Ángel

Díaz

et al. 2002

Infectious Diseases in Obstetrics and Gynecology

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“…In comparison to flora cultured from women with salpingitis uncomplicated by a TOA, we noted greater numbers and variety of anaerobic and aerobic bacteria 12,13 . The flora isolated from these abscesses often included members of the B. fragilis group (18%) and Enterobacteriaceae (50%) and therefore more closely resembled gut flora.…”

Section: Discussionmentioning

confidence: 75%

Etiology of Persistent Tubo‐Ovarian Abscess in Nairobi, Kenya

Cohen

Gravelle

Symekher

et al. 2002

Infectious Diseases in Obstetrics and Gynecology

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Objective To study the microbial etiology of tubo-ovarian abscess (TOA). Methods We recruited 11 women in Nairobi, Kenya who failed antibiotic therapy alone and required surgical drainage of a presumptive TOA. Pus from the nine abscesses and two pyosalpinges were collected and cultured for aerobic, facultative and anaerobic microorganisms. Results Eleven women suspected of having a TOA were hospitalized and treated for a median of 6 days (range 3-14 days) prior to surgical drainage of the abscess. Nine (82%) specimens were culture positive. Aerobes were present in all nine specimens. Seven of the nine positive cultures (78%) were polymicrobial and five of the polymicrobial cultures contained both anaerobes and aerobes. Anaerobic Gram-negative bacilli (Prevotella sp., Porphyromonas sp. and Bacteroides sp., Escherichia coli) and Streptococcus sp. (S. viridans and S. agalactiae) were the most common microorganisms isolated. Neisseria gonorrhoeae and Chlamydia trachomatis were not isolated by culture or detected by polymerase chain reaction. Conclusions In Kenya, persistent TOAs are associated with endogenous flora similar to that normally found in the gastrointestinal tract.

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“…Various clinical trials have documented good short-term clinical and bacteriologic response rates regardless of the intensity of anaerobic coverage [40][41][42][43]. However, data on the ability of a given antimicrobial regimen to prevent long-term sequelae are limited.…”

Section: Pelvic Inflammatory Diseasementioning

confidence: 99%

The 1998 CDC sexually transmitted diseases treatment guidelines

Workowski

2000

Curr Infect Dis Rep

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Health care providers who evaluate persons who have or are at risk for sexually transmitted diseases (STDs) should be aware of current national guidelines for STD treatment and should provide assessment and treatment according to these recommendations. The Centers for Disease Control and Prevention STD Treatment Guidelines were developed by using an evidence-based approach incorporating available scientific evidence, specialist knowledge, and consultation with professional organizations and other agencies with diverse perspectives on STD treatment. The guidelines provide recommendations about new antimicrobial agents for the treatment of primary and recurrent genital herpes, a novel patient-applied therapy for genital warts, additional parenteral alternative regimens for the treatment of pelvic inflammatory disease, oral therapy for vaginal candidiasis, and alternative regimens for treatment of chlamydia in pregnancy. Expanded sections in the guidelines also address the management of urethritis, recognition of the acute retroviral syndrome, and the emergence of quinolone-resistant Neisseria gonorrhoeae. Prevention of sexually transmitted hepatitis A and hepatitis B through the use of preexposure vaccinations is discussed.

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Oral Clindamycin and Ciprofloxacin Versus Intramuscular Ceftriaxone and Oral Doxycycline in the Treatment of Mild-to-Moderate Pelvic Inflammatory Disease in Outpatients

Cited by 51 publications

References 22 publications

Accuracy of Five Different Diagnostic Techniques inMild‐to‐Moderate Pelvic Inflammatory Disease

Accuracy of Five Different Diagnostic Techniques inMild‐to‐Moderate Pelvic Inflammatory Disease

Etiology of Persistent Tubo‐Ovarian Abscess in Nairobi, Kenya

The 1998 CDC sexually transmitted diseases treatment guidelines

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