title: Do short-term markers of treatment efficacy predict long-term sequelae of pelvic inflammatory disease?
abstract: OBJECTIVE
  This study was undertaken to assess whether short-term markers, often used to measure clinical cure after treatment for pelvic inflammatory disease, predict sequelae of lack of pregnancy, recurrent pelvic inflammatory disease, and chronic pelvic pain.
  
  
  METHODS
  Women with mild-to-moderate pelvic inflammatory disease were assessed after treatment initiation at 5 days for tenderness (n = 713) and at 30 days for tenderness, cervical infections and endometritis (n = 298). Pregnancy, recurrent pelvic inflammatory disease, and chronic pelvic pain were evaluated after 84 months, on average.
  
  
  RESULTS
  Pelvic tenderness at 5 and at 30 days significantly elevated the risk for developing chronic pelvic pain; tenderness at 30 days was also significantly associated with recurrent pelvic inflammatory disease. However, pelvic tenderness at 5 and at 30 days was only modestly clinically predictive of chronic pelvic pain or recurrent pelvic inflammatory disease (positive predictive values 22.1-66.9%). No short-term marker significantly influenced the likelihood of achieving a pregnancy.
  
  
  CONCLUSIONS
  Tenderness at 5 or 30 days did not accurately predict the occurrence of pelvic inflammatory disease-related reproductive morbidities.
authors.affiliation: University of Pittsburgh School of Public Health, Pittsburgh, PA 15261, USA.
authors.forename: Gail M
authors.initials: GM
authors.lastname: Trautmann
authors.forename: Kevin E
authors.initials: KE
authors.lastname: Kip
authors.forename: Holly E
authors.initials: HE
authors.lastname: Richter
authors.forename: David E
authors.initials: DE
authors.lastname: Soper
authors.forename: Jeffrey F
authors.initials: JF
authors.lastname: Peipert
authors.forename: Deborah B
authors.initials: DB
authors.lastname: Nelson
authors.forename: Wayne
authors.initials: W
authors.lastname: Trout
authors.forename: Dianne
authors.initials: D
authors.lastname: Schubeck
authors.forename: Debra C
authors.initials: DC
authors.lastname: Bass
authors.forename: Roberta B
authors.initials: RB
authors.lastname: Ness
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D002440:Cefoxitin / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D004318:Doxycycline / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007247:Infertility, Female; D018836:Inflammation Mediators / Q000032:analysis; D007262:Infusions, Intravenous; D010147:Pain Measurement; D000292:Pelvic Inflammatory Disease / Q000175:diagnosis* / Q000188:drug therapy*; D011237:Predictive Value of Tests; D011336:Probability; D011339:Probenecid / Q000008:administration & dosage*; D016016:Proportional Hazards Models; D012008:Recurrence; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D018836:Inflammation Mediators; D002440:Cefoxitin; D004318:Doxycycline; D011339:Probenecid