Pelvic Inflammatory Disease Treatment

Treatment usually involves sexual abstinence or condom use, for two weeks. Special diets are not required but it is important that the affected person to rest and take a medical reevaluation than 48 hours after starting antibiotic treatment.

Antimicrobial treatment should cover N gonorrhoeae and C trachomatis. Indicate simultaneous treatment of sexual partner if found N gonorrhoeae or C trachomatis.

According to the schemes recommended by the Centers for Disease Control (CDC, Atlanta) in the treatment of acute PID during pregnancy the agents of choice are clindamycin combined with gentamicin, the tetracyclines are contraindicated.

It is reserved for those patients that are suspected pelvic abscess, and having the following characteristics: acute abdomen, septic shock, persistent bacteremia, failure of conservative treatment (48-72 hours), bacteremia, fever, peritonitis and ileus persistent tumor was growing, persistent laboratory abnormalities, patients with no desire for fertility.

The pharmacological treatment of pelvic abscess combines the following antibiotics: clindamycin 900 mg IV c/8h or metronidazole 1 g IV c/12h more garamicina 2 mg / kg initial dose followed by 1.5 mg / kg c/8h. There are studies that relate the association between aztreonam plus clindamycin with a cure rate up to 97.7%.

Surgical treatment should be as conservative as possible. Posterior colpotomy is the policy making if there is abscess pouch of Douglas. The rupture of the abscess with generalized peritonitis should be considered and treated as a surgical emergency, usually total abdominal hysterectomy with bilateral salpingo or forectomía.