title: Susceptibility of upper-genital tract isolates from women with pelvic inflammatory disease to ampicillin, cefpodoxime, metronidazole, and doxycycline.
abstract: The antibiotics that are recommended for treatment of pelvic inflammatory disease (PID) in the outpatient setting are efficacious against Neisseria gonorrhoeae and Chlamydia trachomatis. The susceptibility of non-sexually transmitted pathogens to these agents has not been well studied. The mean inhibitory concentrations of ampicillin, cefpodoxime, metronidazole, and doxycycline were determined for 137 upper-genital tract isolates from 84 women with confirmed PID. Antibiotic resistance was noted in 16%, 9%, 93%, and 72% of the facultative and 0%, 11%, 10%, and 56% of the anaerobic bacteria when tested against ampicillin, cefpodoxime, metronidazole, and doxycycline, respectively. The authors conclude that doxycycline is limited to coverage of Chlamydia and that a single dose of another antibiotic may not be adequate to eradicate the non-sexually transmitted disease pathogens from the upper-genital tract. Additional clinical and microbiologic studies are needed to determine whether the current outpatient antibiotic regimens provide optimal coverage for the non-sexually transmitted pathogens that are associated with PID.
authors.affiliation: Department of Obstetrics and Gynecology, University of Washington, Seattle 98195.
authors.forename: M B
authors.initials: MB
authors.lastname: Hasselquist
authors.forename: S
authors.initials: S
authors.lastname: Hillier
mesh_terms: D000667:Ampicillin / Q000494:pharmacology; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001419:Bacteria / Q000187:drug effects*; D015296:Ceftizoxime / Q000031:analogs & derivatives / Q000494:pharmacology; D004318:Doxycycline / Q000494:pharmacology; D005260:Female; D005836:Genitalia, Female / Q000382:microbiology*; D006801:Humans; D008795:Metronidazole / Q000494:pharmacology*; D008826:Microbial Sensitivity Tests; D000292:Pelvic Inflammatory Disease / Q000382:microbiology*; D000097623:Cefpodoxime
chemical_list: D000667:Ampicillin; D000900:Anti-Bacterial Agents; D015296:Ceftizoxime; D004318:Doxycycline; D008795:Metronidazole; D000097623:Cefpodoxime