If pelvic inflammatory disease is suspected empiric treatment should be initiated.
OBJECTIVE
To assist the nurse practitioner (NP) to make a rapid diagnosis and develop a treatment plan for pelvic inflammatory disease (PID) in order to assist women to promote their health and reduce their risk of the unnecessary sequelae of infertility, tubal damage, and the possibility of a subsequent ectopic pregnancy.


METHODS
Centers for Disease Control guidelines and recent clinical practice literature were searched to provide guidance on how to diagnose, treat, and educate the patient with PID.


CONCLUSIONS
The incidence of PID is approximately 1 million women annually. PID is diagnosed in 1%-2% of sexually active women under the age of 25, with a higher incidence in African American women. Women with PID produce over 2 million emergency room and office visits and incur health care costs of over 4 billion dollars annually.


CONCLUSIONS
PID is associated with chronic pelvic pain, infertility, and ectopic pregnancy. Symptoms can range from subtle and indolent to acute and fulminant. Having a high index of suspicion for the diagnosis will assist the NP in treating patients with this disease. Empiric antibiotic therapy should be initiated in all women at risk who have uterine, adnexal, or cervical motion tenderness on a bimanual exam with no other explanation for these symptoms. Without response to treatment, if the diagnosis is unclear, or if a surgical emergency is being considered, prompt referral to a specialist is warranted. Secondary preventive measures are discussed.
Abatangelo
Lisa
L
School of Nursing, University of Medicine and Dentistry of New Jersey, Newark, New Jersey 07103, USA.
Okereke
Lilian
L
Parham-Foster
Cheryle
C
Parrish
Colleen
C
Scaglione
Leanne
L
Zotte
Deborah
D
Taub
Leslie-Faith Morritt
LF
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003937:Diagnosis, Differential; D005260:Female; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D007247:Infertility, Female / Q000209:etiology; D009722:Nurse Practitioners / Q000458:organization & administration*; D024802:Nurse's Role; D010353:Patient Education as Topic; D018579:Patient Selection; D000292:Pelvic Inflammatory Disease / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D017699:Pelvic Pain / Q000209:etiology; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000209:etiology; D015995:Prevalence; D011320:Primary Health Care / Q000458:organization & administration*; D012017:Referral and Consultation; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
D000900:Anti-Bacterial Agents