Second look laparoscopy; evaluation of two different antibiotic regimens after treatment of acute salpingitis.
In order to have their diagnoses verified, etiology determined and treatment evaluated, 64 patients with suspected acute salpingitis (AS) underwent laparoscopy during which specimens were taken. The patients were referred to groups of either a mild (16/64), a moderate (26/64), or a severe (22/64) form of salpingitis. They were then randomized to one of two groups for treatment with either doxycycline/bensylpenicillin-procain (DC/BP) or trimethoprim-sulfamethoxazole (TMP-SMZ). The results were evaluated by second-look laparoscopy 3-6 months later when adhesions and tubal passage were looked for. Isolates from the cervix were culture positive for Chlamydia trachomatis (CT) in 36/64 (56%) (9/16 with a mild form, 13/26 with moderate form and 14/22 with a severe form of salpingitis). Neisseria gonorrhoeae (NG) was isolated from the cervix in 15/64 (23%) (5/16 with a mild form, 4/26 with a moderate form and 6/22 with a severe form of the disease). Oviductal cultures for CT were found in 12/64 (19%) (1/16 with a mild form, 4/26 with a moderate and 7/25 with severe form of salpingitis). Oviductal isolates for NG were found in 2/64 (13%) (2/16 from the group with a mild form of the disease). Second-look laparoscopy revealed totally occluded oviducts in two patients from the group with a severe form of salpingitis (one from each treatment group).
Brihmer
C
C
Department of Obstetrics and Gynaecology, Karolinska Institutet Danderyd Hospital, Sweden.
Kallings
I
I
Nord
C E
CE
Brundin
J
J
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D001419:Bacteria / Q000302:isolation & purification; D002584:Cervix Uteri / Q000382:microbiology; D004318:Doxycycline / Q000008:administration & dosage / Q000627:therapeutic use; D004338:Drug Combinations / Q000008:administration & dosage / Q000627:therapeutic use; D004359:Drug Therapy, Combination / Q000627:therapeutic use*; D005187:Fallopian Tubes / Q000382:microbiology; D005260:Female; D006801:Humans; D010535:Laparoscopy; D010402:Penicillin G Procaine / Q000008:administration & dosage / Q000627:therapeutic use; D011446:Prospective Studies; D011897:Random Allocation; D012488:Salpingitis / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology; D013420:Sulfamethoxazole / Q000008:administration & dosage / Q000627:therapeutic use; D014295:Trimethoprim / Q000008:administration & dosage / Q000627:therapeutic use; D015662:Trimethoprim, Sulfamethoxazole Drug Combination
D004338:Drug Combinations; D010402:Penicillin G Procaine; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D014295:Trimethoprim; D013420:Sulfamethoxazole; D004318:Doxycycline