Ciprofloxacin-tinidazole combination, fluconazole- azithromicin-secnidazole-kit and doxycycline- metronidazole combination therapy in syndromic management of pelvic inflammatory disease: a prospective randomized controlled trial.
BACKGROUND
Pelvic inflammatory disease is a common problem faced by the gynecologists in there out patient department.


OBJECTIVE
The aim of the study was to evaluate the efficacy of three treatment combinations in the syndromic management of pelvic inflammatory disease in the out patient setting. SETTING DESIGN: In the medical college hospital patients presenting in gynecology out patient department were enrolled.


METHODS
One hundred and sixty five women with diagnosis of pelvic inflammatory disease were randomized into three equal groups getting ciprofloxacin (500 mg) and tinidazole (600 mg) combination twice daily for 7 days (Group 1), a kit containing fluconazole (150 mg), azithromycin (1 gm) and secnidazole (2 mg) as one time dose (Group 2) and Doxycycline 100mg twice daily and metronidazole 200 mg thrice daily for seven days (Group 3). Severity score was determined on first visit and after 1 week and 4 weeks when patients were called for follow up.


METHODS
Chisqare test, Krusker wallis test and Mann Whitney test.


RESULTS
There was significant reduction in severity score after 1 week of treatment, which was further reduced after 4 weeks in all the three groups. Cure rate was highest in-group 1 (96%) followed by group 2 (93.5) and group 3 (91.3%) but the difference was not statistically significant. Resolution of inflammatory mass was highest in group 1. The incidence of side effects was highest and compliance was lowest in the doxycycline -metronidazole group, but the difference was not statistically significant.


CONCLUSIONS
All the three treatment combinations were found to be equally effective in the syndromic management of pelvic inflammatory disease.
Malhotra
M
M
Department of Obstetrics & Gynaecology and Biostatistics, Maulana Azad Medical College & Associated Lok Nayak Hospital, New Delhi - 110 002, India.
Sharma
J B
JB
Batra
S
S
Arora
R
R
Sharma
S
S
D000293:Adolescent; D000328:Adult; D017963:Azithromycin / Q000008:administration & dosage*; D002939:Ciprofloxacin / Q000008:administration & dosage*; D004318:Doxycycline / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D005260:Female; D015725:Fluconazole / Q000008:administration & dosage*; D006801:Humans; D008795:Metronidazole / Q000008:administration & dosage* / Q000031:analogs & derivatives*; D000292:Pelvic Inflammatory Disease / Q000188:drug therapy*; D011446:Prospective Studies; D014011:Tinidazole / Q000008:administration & dosage*
D014011:Tinidazole; D008795:Metronidazole; D002939:Ciprofloxacin; D017963:Azithromycin; D015725:Fluconazole; D004318:Doxycycline; C016724:secnidazole