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  • Title: How to treat PID.
    Author: Cates W, Weisner PJ, Goodrich JT.
    Journal: Contracept Technol Update; 1982 Aug; 3(8):102-3. PubMed ID: 12265536.
    Abstract:
    Once the condition of pelvic inflammatory disease (PID) has been diagnosed clinicans should initiate immediate therapy. If antibiotics are withheld until a specific microbiologic diagnosis is obtained, the possibility of laboratory error and of processing delays hinders appropriate therapy. Evolving knowledge of the definition, etiology, and treatment of PID provides additional rationale for immediate antibiotic administration. PID, which refers to the clinical syndrome attributed to the ascending spread of microorganisms from the vaginal and endocervix to the fallopian tubes and contiguous structures, includes the clinical entities of endometritis, salpingitis, and parametritis, and/or peritonitis. Clinical diagnosis usually involves a history of lower abdominal pain, lower abdominal tenderness, cervical motion tenderness, and adnexal tenderness. Many organisms play a role in the pathogenesis of this syndrome, and clinicians should initiate treatment regimens which are active against the broadest range of pathogens. The treatment of choice is not established. No single agent is active against the entire spectrum of pathogens. Several antimicrobial combinations provide broad spectrum activity against the major pathogens in vitro, but many have not been adequatley evaluated for clinical efficacy in PID. Drugs with optimal anaerobic activity are perferred in patients with a pelvic mass or IUD associated PID. In most other women, drugs with optimal activity against N. gonorrhoea and C. trachomatis may be preferred. Due to the severe longterm complications resulting from PID, including infertility and ectopic pregnancy, clinicians should seriously consider hospitalizing women with PID whenever practical. Criteria for hospitalization are outlined.
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