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BMJ (Clinical Research Ed.) Apr 1990
Review
Topics: Adolescent; Adult; Anti-Bacterial Agents; Drug Therapy, Combination; Female; Humans; Pelvic Inflammatory Disease
PubMed: 2188699
DOI: 10.1136/bmj.300.6732.1090 -
The Medical Clinics of North America Nov 1990The costs of PID to both individuals and society are enormous. Although primary prevention of PID through control of lower genital tract infections is the most effective... (Review)
Review
The costs of PID to both individuals and society are enormous. Although primary prevention of PID through control of lower genital tract infections is the most effective prevention strategy, early diagnosis and treatment of acute PID may minimize some of its serious sequelae. Although laparoscopy is helpful for establishing the diagnosis of salpingitis, other less invasive tests along with selected clinical criteria may also be useful. Treatment of PID, which is empiric and broad spectrum, is oriented toward polymicrobial PID. Whenever possible, women with PID should be hospitalized for parenteral therapy. The 1989 CDC STD treatment guidelines recommend two regimens for inpatient parenteral therapy: clindamycin/gentamicin and cefoxitin, or equivalent cephalosporin/doxycycline. Outpatient management of PID should be monitored closely; the CDC-recommended regimen includes use of intramuscular cephalosporins and oral doxycycline. Oral penicillins are no longer recommended.
Topics: Diagnosis, Differential; Female; Humans; Pelvic Inflammatory Disease; Sexually Transmitted Diseases
PubMed: 2246955
DOI: 10.1016/s0025-7125(16)30497-7 -
Sexually Transmitted Diseases 1986Acute pelvic inflammatory disease (PID) is a major public health problem. An estimated 1 million cases occur annually in the United States. PID is a major cause of... (Review)
Review
Acute pelvic inflammatory disease (PID) is a major public health problem. An estimated 1 million cases occur annually in the United States. PID is a major cause of infertility and ectopic pregnancy. Prevention of the significant medical and economic sequelae of acute PID relies on the institution of appropriate treatment regimens that are based on the true microbiologic etiology of acute PID and take cognizance of the polymicrobic nature of this etiology. The clinician must maintain a high index of suspicion for acute PID so that early diagnosis can be made and treatment begun. Hospitalization and utilization of parenteral antimicrobial therapy will be of greatest benefit to the patient. This therapy should include combination agents that provide coverage for Neisseria gonorrhoeae, Chlamydia trachomatis, anaerobes (including Bacteroids and anaerobic cocci), gram-negative aerobic rods, and gram-positive aerobes (including group B Streptococcus). Finally, to prevent repeated infection, it is crucial to locate the sexual partners of women with acute PID and to screen and treat them for sexually transmitted diseases. In this way, the recurrent infections, which lead to a poor prognosis for fertility, can be avoided.
Topics: Anti-Bacterial Agents; Female; Humans; Pelvic Inflammatory Disease; Risk; United States
PubMed: 3532371
DOI: 10.1097/00007435-198607000-00020 -
Current Opinion in Obstetrics &... Oct 2006We discuss the epidemiology, risk factors, microbiology, diagnosis, treatment and prevention of pelvic inflammatory disease in adolescents. (Review)
Review
PURPOSE OF REVIEW
We discuss the epidemiology, risk factors, microbiology, diagnosis, treatment and prevention of pelvic inflammatory disease in adolescents.
RECENT FINDINGS
Young age is one of the most important risk factors for sexually transmitted diseases and pelvic inflammatory disease. Sexually active adolescents have the highest incidence of Chlamydia trachomatis, Neisseria gonorrhoeae, and pelvic inflammatory disease of any sexually active age group. Long-term sequelae of pelvic inflammatory disease include ectopic pregnancy, tubal factor infertility, tubo-ovarian abscesses and chronic pelvic pain. Subclinical pelvic inflammatory disease is responsible for a significant portion of these long-term sequelae. New (2006) Centers for Disease Control and Prevention treatment guidelines for pelvic inflammatory disease are available. One of the best methods of prevention of pelvic inflammatory disease is to screen and treat sexually active adolescents for chlamydial infection. Implementation of nucleic acid amplification assays allows screening of adolescents via self-collected urine or vaginal swab samples.
SUMMARY
Pelvic inflammatory disease is a highly preventable source of reproductive morbidity for adolescents. It is prudent that clinicians provide counseling regarding healthy sexual behaviors, STD prevention, and contraception whenever an adolescent presents in need of STD screening or evaluation for pelvic inflammatory disease.
Topics: Adolescent; Age Factors; Anti-Bacterial Agents; Child; Chlamydia Infections; Chlamydia trachomatis; Diagnosis, Differential; Female; Gonorrhea; Health Education; Humans; Pelvic Inflammatory Disease; Practice Guidelines as Topic; Risk Factors; Sexual Behavior; Sexually Transmitted Diseases
PubMed: 16932044
DOI: 10.1097/01.gco.0000242952.87125.69 -
Current Opinion in Obstetrics &... Oct 1992Pelvic inflammatory disease is a common serious complication of the sexually transmitted pathogens Neisseria gonorrhoeae and Chlamydia trachomatis. There are more than... (Review)
Review
Pelvic inflammatory disease is a common serious complication of the sexually transmitted pathogens Neisseria gonorrhoeae and Chlamydia trachomatis. There are more than 800,000 cases of pelvic inflammatory disease annually accounting for approximately 200,000 hospital admissions for acute and chronic infections. Early accurate diagnosis and treatment are essential to prevent the serious sequelae including ectopic pregnancy, tubal disease infertility, chronic pain, and disability requiring multiple hospitalizations and surgery. Although clinical models to aid in the diagnosis and management of pelvic inflammatory disease have been developed by numerous investigators, all have lacked the sensitivity and specificity to be helpful to the clinician. Laparoscopy, considered by many to be the "gold standard" for diagnosis, is underutilized, and the definition of pelvic infection differs between investigators. Improved patient compliance and safety may be seen if single-agent therapy for acute pelvic inflammatory disease becomes a reality. In a small prospective randomized study, oral ofloxacin was as effective as cefoxitin plus doxycycline for outpatient treatment of chlamydial and gonococcal pelvic inflammatory disease. Treatment of tuboovarian abscess appears to be successful with single agent and combination therapy. Risk factors for developing postabortion endometritis continue to be identified, and the most efficacious prophylactic antibiotic regimen has not been determined to date.
Topics: Abortion, Legal; Anti-Bacterial Agents; Clinical Protocols; Drug Resistance, Microbial; Endometritis; Female; Humans; Incidence; Laparoscopy; Patient Admission; Pelvic Inflammatory Disease
PubMed: 1391639
DOI: No ID Found -
Seminars in Dermatology Jun 1990Pelvic inflammatory disease (PID) and PID-related sequelae have risen to alarming proportions and are a major public health problem. During the last two decades, an... (Review)
Review
Pelvic inflammatory disease (PID) and PID-related sequelae have risen to alarming proportions and are a major public health problem. During the last two decades, an epidemic of sexually transmitted diseases has led to an epidemic of PID that has now led to a secondary epidemic of tubal infertility and ectopic pregnancies. The direct and indirect economic consequences caused by PID to the community are enormous. The spectrum of clinical manifestations of PID is extremely broad, leading to major diagnostic problems in clinical practice. Although PID is the most preventable cause of tubal damage, PID and PID-related sequelae remain one of the most neglected areas in modern medicine. Prevention of PID should be the main goal of the appropriate diagnosis and treatment of lower genital tract infections. Only better understanding of the risk factors, microbial etiology, pathophysiology, immunopathology, and manifestation of PID can ultimately lead to improved therapeutic results and decrease in the current epidemic of acute, chronic, and late complications of PID.
Topics: Female; Humans; Pelvic Inflammatory Disease; Pregnancy; Risk Factors
PubMed: 2202408
DOI: No ID Found -
JAMA Nov 1991Effective strategies for preventing pelvic inflammatory disease (PID) are crucial to protect women from adverse reproductive consequences and to avoid substantial... (Review)
Review
Effective strategies for preventing pelvic inflammatory disease (PID) are crucial to protect women from adverse reproductive consequences and to avoid substantial economic losses. To identify current PID prevention options and assess their efficacy, we conducted a literature search and examined relevant data in published reports. We organized our review by level of participation (ie, individuals, providers, and communities) and prevention (ie, primary, secondary, and tertiary). For individuals, several prevention strategies related to personal protection appear promising, but few have been appropriately evaluated. For providers of health care, five prevention measures are recommended, including such primary prevention activities as counseling and patient education in addition to the usual diagnosis and treatment. Specific evidence supporting the efficacy of these provider practices, however, is limited. For communities, maintaining comprehensive sexually transmitted disease control strategies to prevent lower genital tract chlamydial and gonococcal infection is most important in reducing both symptomatic and asymptomatic PID. We provide specific recommendations for preventing PID and outline research needs.
Topics: Contraceptive Devices, Female; Contraceptive Devices, Male; Counseling; Female; Health Promotion; Health Services Accessibility; Humans; Patient Acceptance of Health Care; Patient Education as Topic; Pelvic Inflammatory Disease; Sexual Behavior
PubMed: 1942403
DOI: No ID Found -
Singapore Medical Journal Nov 2023
Review
Topics: Female; Humans; Pelvic Inflammatory Disease; Intrauterine Devices
PubMed: 35139625
DOI: 10.11622/smedj.2022021 -
Seminars in Pediatric Infectious... Jul 2005Pelvic inflammatory disease (PID) is a polymicrobial infection typically occurring in sexually active females. It occurs when microorganisms ascend from the lower... (Review)
Review
Pelvic inflammatory disease (PID) is a polymicrobial infection typically occurring in sexually active females. It occurs when microorganisms ascend from the lower genital tract into the upper genital tract. The clinical presentation varies in severity, with most patients presenting with mild disease. Complications include tubo-ovarian abscess, ectopic pregnancy, infertility, and chronic pain. The newly revised criteria issued by the Centers for Disease Control and Prevention now include either cervical motion tenderness or adnexal tenderness with unchanged additional criteria.
Topics: Adolescent; Anti-Bacterial Agents; Female; Humans; Pelvic Inflammatory Disease; Risk Factors; Sexually Transmitted Diseases
PubMed: 16044391
DOI: 10.1053/j.spid.2005.04.006 -
European Journal of Obstetrics,... Oct 2000Pelvic inflammatory disease (PID) refers to infection of the uterus (endometritis), fallopian tubes (salpingitis) and adjacent pelvic structures (tubo-ovarain complex,... (Review)
Review
Pelvic inflammatory disease (PID) refers to infection of the uterus (endometritis), fallopian tubes (salpingitis) and adjacent pelvic structures (tubo-ovarain complex, pelvic peritonitis). PID causes major medical, social, and economic problems. Long-term sequelae, especially tubal factor infertility and extra uterine pregnancy are common and their management is extremely costly. Medical treatment of PID should be immediate because sequelae are more frequent if the treatment is delayed or inadequate.
Topics: Anti-Bacterial Agents; Chlamydia Infections; Chlamydia trachomatis; Female; Gonorrhea; Hospitalization; Humans; Pelvic Inflammatory Disease; Pregnancy
PubMed: 10996679
DOI: 10.1016/s0301-2115(99)00279-1