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Australian Family Physician Nov 2006Pelvic inflammatory disease (PID) is a treatable condition with serious long term sequelae. The recognition and diagnosis of PID can be challenging due to the wide... (Review)
Review
BACKGROUND
Pelvic inflammatory disease (PID) is a treatable condition with serious long term sequelae. The recognition and diagnosis of PID can be challenging due to the wide spectrum of disease and clinical presentation.
OBJECTIVE
This article discusses the presentation, aetiology, diagnosis, management, and prevention of PID.
DISCUSSION
A high index of suspicion and a low threshold for treatment for women at risk of PID may help decrease the burden of serious associated morbidity. Screening for chlamydia in young sexually active women may reduce the incidence of PID.
Topics: Algorithms; Female; Humans; Pelvic Inflammatory Disease; Risk Factors
PubMed: 17099803
DOI: No ID Found -
Pediatrics Aug 2018Women with pelvic inflammatory disease (PID) are at an increased risk for syphilis and HIV, but screening rates among adolescents have been understudied. Our objective...
BACKGROUND AND OBJECTIVES
Women with pelvic inflammatory disease (PID) are at an increased risk for syphilis and HIV, but screening rates among adolescents have been understudied. Our objective is to measure the frequency of HIV and syphilis screening among adolescents who are diagnosed with PID and identify patient- and hospital-level characteristics associated with screening.
METHODS
We performed a retrospective cohort study using the Pediatric Health Information System from 2010 to 2015. We included visits to the emergency department by female adolescents who were diagnosed with PID and determined the frequency of HIV and syphilis screening. We performed separate multivariable logistic regression analyses to identify factors associated with screening.
RESULTS
Of the 10 698 patients who were diagnosed with PID, 22.0% (95% confidence interval [CI] 21.2%-22.8%) underwent HIV screening, and 27.7% (95% CI 26.9%-28.6%) underwent syphilis screening. Screening rates varied by hospital (HIV: 2.6%-60.4%; syphilis: 2.9%-62.2%). HIV screening was more likely to occur in younger (adjusted odds ratio [aOR] 1.2; 95% CI 1.0-1.3), non-Hispanic African American (aOR 1.4; 95% CI 1.2-1.7), non-privately insured (publicly insured [aOR 1.3; 95% CI 1.1-1.5], uninsured [aOR 1.6; 95% CI 1.2-2.0]), and admitted patients (aOR 7.0; 95% CI 5.1-9.4) at smaller hospitals (aOR 1.4; 95% CI 1.0-1.8). Syphilis screening was more likely to occur in younger (aOR 1.1; 95% CI 1.0-1.3), non-Hispanic African American (aOR 1.8; 95% CI 1.2-2.8), non-privately insured (publicly insured [aOR 1.4; 95% CI 1.2-1.6], uninsured [aOR 1.6; 95% CI 1.2-1.9]), and admitted patients (aOR 4.6; 95% CI 3.3-6.4).
CONCLUSIONS
We found low rates of HIV and syphilis screening among adolescents who were diagnosed with PID, with wide variability across hospitals.
Topics: Adolescent; Child; Emergency Service, Hospital; Female; HIV Infections; Humans; Mass Screening; Pelvic Inflammatory Disease; Retrospective Studies; Syphilis; Young Adult
PubMed: 30042114
DOI: 10.1542/peds.2017-4061 -
European Review For Medical and... Jun 2018Tigecycline is a glycylcycline antimicrobial structurally related to minocycline, with a wide spectrum of activity that includes anaerobes and typical and atypical...
OBJECTIVE
Tigecycline is a glycylcycline antimicrobial structurally related to minocycline, with a wide spectrum of activity that includes anaerobes and typical and atypical microorganisms causing pelvic inflammatory disease (PID). This study aimed to evaluate efficacy and safety of tigecycline in complicated PID and un-complicated PID after the failure of first-line antibiotic therapy.
PATIENTS AND METHODS
Between May 2014 and April 2016 at the 2nd Unit of Obstetrics and Gynecology, Santa Chiara Hospital of Pisa a pilot study on 20 women with mild/moderate PID after the failure of first-line antibiotic therapy and on 8 women with complicated PID was conducted. The treatment protocol was 10-day course of tigecycline, with a loading dose of 100 mg intravenously (i.v.) at day one and then 50 mg IV twice daily. The primary endpoint was to evaluate tigecycline's efficacy in terms of clinical response to test-of-cure (TOC) at the end of therapy and 30 days after the last dose. Clinical response during therapy and safety were analyzed as well.
RESULTS
A total of 28 women were enrolled, and 25 patients completed the study protocol, because 3 patients reported adverse drug effects resulting in treatment interruption. PID was mainly caused by Chlamydia, Gardnerella, Mycoplasma/Ureaplasma. Tigecycline showed a 100% remission of signs and symptoms in patients resistant to first-line antibiotic regimen and in patients with complicated PID. Moreover, tigecycline showed good tolerability and compliance.
CONCLUSIONS
Despite the limited sample size, tigecycline seemed an effective and safe treatment for women with complicated/resistant PID. Nevertheless, further clinical trials are needed to confirm these results.
Topics: Adult; Anti-Bacterial Agents; C-Reactive Protein; Dose-Response Relationship, Drug; Female; Gastritis; Humans; Injections, Intravenous; Middle Aged; Nausea; Pelvic Inflammatory Disease; Pilot Projects; Remission Induction; Severity of Illness Index; Tigecycline; Young Adult
PubMed: 29917214
DOI: 10.26355/eurrev_201806_15186 -
The Journal of the American Osteopathic... Jul 2020
Topics: Female; Gonorrhea; Hepatitis; Humans; Pelvic Inflammatory Disease; Peritonitis
PubMed: 32598463
DOI: No ID Found -
Infectious Diseases in Obstetrics and... 2011Pelvic inflammatory disease (PID), one of the most common infections in nonpregnant women of reproductive age, remains an important public health problem. It is... (Review)
Review
Pelvic inflammatory disease (PID), one of the most common infections in nonpregnant women of reproductive age, remains an important public health problem. It is associated with major long-term sequelae, including tubal factor infertility, ectopic pregnancy, and chronic pelvic pain. In addition, treatment of acute PID and its complications incurs substantial health care costs. Prevention of these long-term sequelae is dependent upon development of treatment strategies based on knowledge of the microbiologic etiology of acute PID. It is well accepted that acute PID is a polymicrobic infection. The sexually transmitted organisms, Neisseria gonorrhoeae and Chlamydia trachomatis, are present in many cases, and microorganisms comprising the endogenous vaginal and cervical flora are frequently associated with PID. This includes anaerobic and facultative bacteria, similar to those associated with bacterial vaginosis. Genital tract mycoplasmas, most importantly Mycoplasma genitalium, have recently also been implicated as a cause of acute PID. As a consequence, treatment regimens for acute PID should provide broad spectrum coverage that is effective against these microorganisms.
Topics: Acute Disease; Adult; Anti-Bacterial Agents; Female; Humans; Pelvic Inflammatory Disease
PubMed: 22228985
DOI: 10.1155/2011/561909 -
Sexually Transmitted Infections Sep 2020We sought to determine whether the relationship between a history of vaginal douching and pelvic inflammatory disease (PID) is mediated by endometrial infection with one...
OBJECTIVES
We sought to determine whether the relationship between a history of vaginal douching and pelvic inflammatory disease (PID) is mediated by endometrial infection with one or more novel bacterial vaginosis (BV)-associated organisms among , the BV-associated bacterium 1 (BVAB1), () and .
METHODS
We first conducted log-binomial regression analyses to identify risk factors for endometrial infection in 535 adolescent and adult women with clinically suspected PID in the PID Evaluation and Clinical Health (PEACH) study. We then examined whether endometrial infection by the BV-associated organisms mediated the association between a history of vaginal douching and histologically confirmed PID using inverse probability weighted marginal structural models.
RESULTS
Vaginal douching was significantly associated with endometrial infection with one or more of the targeted BV-associated organisms (relative risk (RR) 1.21, 95% CI: 1.08 to 1.35). The total effect estimate suggested that vaginal douching increased the risk of endometritis by 24% (RR 1.24, 95% CI: 1.03 to 1.49). The controlled direct effect of this association was attenuated with endometrial infection by one or more BV-associated organisms (adjusted RR (aRR) 1.00, 95% CI: 0.57 to 1.74) and endometrial infection by all four BV-associated organisms (aRR 0.95, 95% CI: 0.53 to 1.70) as intermediate variables.
CONCLUSIONS
Endometrial infection with one or more of the novel BV-associated organisms partially mediated the relationship between vaginal douching and histologically confirmed endometritis in the PEACH study. Frequent vaginal douching may confer risk for endometritis through increasing the risk of endometrial infection by novel-BV-associated organisms. Other potential pathways should be explored.
Topics: Actinobacteria; Adolescent; Adult; Endometritis; Female; Fusobacteria; Gram-Negative Bacterial Infections; Gram-Positive Bacterial Infections; Humans; Pelvic Inflammatory Disease; United States; Vaginal Douching; Vaginosis, Bacterial; Young Adult
PubMed: 31810995
DOI: 10.1136/sextrans-2019-054191 -
Current Opinion in Obstetrics &... Oct 2013Pelvic inflammatory disease (PID) is a common and serious reproductive health disorder and disease rates remain unacceptably high among adolescent girls and young adult... (Review)
Review
PURPOSE OF REVIEW
Pelvic inflammatory disease (PID) is a common and serious reproductive health disorder and disease rates remain unacceptably high among adolescent girls and young adult women in the United States. Despite data demonstrating that women experience major adverse health outcomes after PID, national recommendations for management of adolescents have become increasingly less cautious in an era of cost-containment. In this review, we take an alternative look at published data on adolescents with PID to frame the next steps for optimizing management for this vulnerable population.
RECENT FINDINGS
Several findings emerge from review of the literature. First, there is limited evidence to guide the best practice strategies for adolescents with PID due to low enrolment of early and middle adolescents in national trials. Second, adolescents and adult women in the United States receive suboptimal treatment regimens per Centers for Disease Control and Prevention (CDC) standards. Third, available evidence suggests that adolescents are at an increased risk for poor adherence to CDC recommendations for self-care, reacquisition of sexually transmitted infections (STIs) and PID, and subsequent adverse reproductive health outcomes.
SUMMARY
Efforts to develop and integrate adolescent-focused, evidence-based strategies for PID management and prevention of subsequent STIs and recurrent PID are warranted.
Topics: Adolescent; Adolescent Behavior; Adolescent Health Services; Ambulatory Care; Anti-Bacterial Agents; Cost-Benefit Analysis; Female; Humans; Infertility, Female; Mass Screening; Medication Adherence; Pelvic Inflammatory Disease; Practice Guidelines as Topic; Risk Assessment; Self Care; Sexually Transmitted Diseases; United States
PubMed: 24018871
DOI: 10.1097/GCO.0b013e328364ea79 -
Annals of Emergency Medicine May 2016Centers for Disease Control and Prevention guidelines recommend follow-up within 72 hours of diagnosis of pelvic inflammatory disease because patients with inadequate... (Randomized Controlled Trial)
Randomized Controlled Trial
STUDY OBJECTIVE
Centers for Disease Control and Prevention guidelines recommend follow-up within 72 hours of diagnosis of pelvic inflammatory disease because patients with inadequate treatment are at increased risk of acute and chronic complications. Follow-up rates in adolescents after diagnosis range between 10% and 16%. The primary objective is to assess the effect of text message reminders to adolescent patients receiving a diagnosis of pelvic inflammatory disease on obtaining follow-up care within 72 hours of emergency department (ED) discharge.
METHODS
This was a single-blinded randomized controlled trial of adolescents receiving a diagnosis of pelvic inflammatory disease in the ED. Patients received standard discharge instructions or standard discharge instructions plus text message reminders. Patients in the text message group received daily, tailored text messages for 4 days, with a reminder to schedule and attend primary care provider follow-up. The primary outcome was follow-up within 72 hours of ED discharge.
RESULTS
Ninety-five patients (48 standard; 47 text message) were randomized. Three patients were excluded, leaving 92 patients (46 standard; 46 text message) for analysis. Baseline characteristics were similar between treatment groups. Follow-up was 15.2% in the standard group and 43.5% in the text message group. Patients receiving text message reminders were more likely to follow up compared with the standard group (relative risk 2.9; 95% confidence interval [CI] 1.4 to 5.7). The absolute efficacy difference was 28.3% (95% CI 9.5% to 46.9%), yielding number needed to treat of 4 (95% CI 2.2 to 9.5).
CONCLUSION
Personalized text message reminders were efficacious in improving follow-up for adolescents after ED diagnosis of pelvic inflammatory disease.
Topics: Adolescent; Adolescent Health Services; Appointments and Schedules; Critical Pathways; Emergency Service, Hospital; Female; Humans; Pelvic Inflammatory Disease; Quality Improvement; Reminder Systems; Single-Blind Method; Text Messaging
PubMed: 26686262
DOI: 10.1016/j.annemergmed.2015.10.022 -
Medicine Feb 2016This study examines whether pelvic inflammatory disease (PID) facilitates the development of intracerebral hemorrhage (ICH).By using outpatient claims data from the... (Observational Study)
Observational Study
This study examines whether pelvic inflammatory disease (PID) facilitates the development of intracerebral hemorrhage (ICH).By using outpatient claims data from the National Health Insurance Research Database (NHIRD) of Taiwan, we included the data of 25,508 patients who were newly diagnosed with PID between 1999 and 2004, and also from the Taiwan NHIRD, we randomly selected 102,032 women without PID, who were frequency-matched by age and entry-year and with 4 times the number of the PID patients, as the control cohort. We measured ICH risks associated with PID and comorbidities, including hyperlipidemia, diabetes, hypertension, ischemic heart disease, and atrial fibrillation, by the end of 2011.In comparison with the controls, the ICH hazard was less in the PID group with an adjusted hazard ratio (aHR) of 0.67 (95% confidence interval [CI]:0.50-0.90), which was noted by calculation with the Cox proportional regression model. The ICH risk in the PID patients reduced progressively with the advance of age, with aHRs of 0.75 (95% CI:0.41-1.39) and 0.50 (95% CI:0.29-0.88), respectively, in the age <35-year and age ≥50-year groups. ICH risk lowered gradually with the progress of PID severity, from mild PID with an aHR of 0.72 (95% CI:0.53-0.98) to severe PID with that of 0.30 (95% CI:0.10-0.92). PID patients without any comorbidites had lower ICH risk (aHR = 0.63, 95% CI:0.42-0.94) than the controls without any comorbidites did.Our findings revealed that PID is associated with reduced ICH development, especially for older patients.
Topics: Adult; Case-Control Studies; Cerebral Hemorrhage; Female; Follow-Up Studies; Humans; Middle Aged; Pelvic Inflammatory Disease; Taiwan
PubMed: 26844517
DOI: 10.1097/MD.0000000000002726 -
MMWR. Recommendations and Reports :... Apr 1991This report provides comprehensive guidelines to aid practitioners and decision makers in achieving PID prevention and management objectives. The main focus of this...
This report provides comprehensive guidelines to aid practitioners and decision makers in achieving PID prevention and management objectives. The main focus of this document is PID related to STD. These guidelines for the prevention and management of PID were established by staff of CDC in consultation with a group of outside experts. Current data regarding the efficacy of prevention strategies and management approaches form the basis for the guidelines. Because data are incomplete, however, certain aspects of these guidelines represent the current consensus judgment of the consulted experts. Recommendations in this document should be considered a source of guidance to health practitioners.
Topics: Anti-Bacterial Agents; Contraception; Drug Therapy, Combination; Female; Humans; Pelvic Inflammatory Disease; Risk Factors; Sex Education; Sexual Behavior; Sexually Transmitted Diseases; Socioeconomic Factors
PubMed: 2034205
DOI: No ID Found