Combination antimicrobial therapy in the treatment of acute pelvic inflammatory disease

Many bacteria can cause pelvic inflammatory disease, and it is possible that multiple species may be responsible for the disease in an individual. In these cases, a single type of antibiotic may not be effective, and combination antimicrobial therapy has been recommended. However, although several regimens have been used, their effectiveness in actual medical practice has not been well-studied. The effectiveness of cefoxitin plus doxycycline was compared with that of clindamycin plus tobramycin in the treatment of pelvic inflammatory disease in 148 women. All antibiotics were administered for a minimum of four days intravenously, and upon discharge from the hospital, a regimen of oral medication was continued for two weeks. An initial satisfactory response to the antibiotics occurred in 97 percent of patients, and response was not different between those with uncomplicated disease and those with abscesses. Neisseria gonorrhoeae and Chlamydia trachomatis (C. trachomatis) were the bacteria most often isolated from patients. C. trachomatis can be especially difficult to remove, and the clindamycin regimen appeared to be more effective in treating this bacterial infection. Mild nausea or diarrhea were the most common side effects of treatment. The results indicate that either regimen is effective and safe in the short-term treatment of pelvic inflammatory disease; the long-term effectiveness of such treatment remains to be determined. (Consumer Summary produced by Reliance Medical Information, Inc.)