Current concepts in managing pelvic inflammatory disease.
OBJECTIVE
The management of pelvic inflammatory disease (PID) has significantly changed during the last two decades. Moreover, some recent bacterial findings have led to recent changes in this management.


RESULTS
Most cases of PID are mild-to-moderate uncomplicated forms that can be treated as outpatients. Apart from Chlamydia trachomatis and Neisseria gonorrhoeae, other pathogens such as Mycoplasma genitalium and bacterial vaginosis (BV)-associated bacteria are playing a significant role in PID and thus must be reckoned with. Moreover, gonococci have increasingly become resistant to the majority of antibiotics. This has led to a universal recommendation to treat N. gonorrhoeae infections with ceftriaxone. A few recent clinical trials have shown that quinolones and azithromycin (with metronidazole) are the best therapeutic options to treat uncomplicated PID.


CONCLUSIONS
The management of PID nowadays must take into account the role of pathogens such as M. genitalium, BV-associated bacteria and multiresistant gonococci.
Judlin
Philippe
P
Department of Gynecology, Obstetrics & Reproduction, Maternite Regionale Universitaire of NANCY, Nancy, France. p.judlin@maternite.chu-nancy.fr
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy / Q000382:microbiology; D002690:Chlamydia Infections / Q000188:drug therapy / Q000382:microbiology; D002692:Chlamydia trachomatis; D005260:Female; D006069:Gonorrhea / Q000188:drug therapy / Q000382:microbiology; D006801:Humans; D009344:Neisseria gonorrhoeae; D000292:Pelvic Inflammatory Disease / Q000188:drug therapy* / Q000382:microbiology*
D000900:Anti-Bacterial Agents