title: Image-guided drainage versus antibiotic-only treatment of pelvic abscesses: short-term and long-term outcomes.
abstract: OBJECTIVE
  To determine the efficacy of image-guided drainage versus antibiotic-only treatment of pelvic abscesses.
  
  
  METHODS
  Retrospective cohort analysis.
  
  
  METHODS
  An academic, inner-city medical center.
  
  
  METHODS
  Women ages 11-49, admitted between 1998 and 2008 with ICD9 code 614.x (inflammatory diseases of ovary, fallopian tube, pelvic cellular tissue, and peritoneum).
  
  
  METHODS
  Medical records search, chart review, and phone survey.
  
  
  METHODS
  Surgical intervention.
  
  
  RESULTS
  We identified 6,151 initial patients, of whom 240 patients met inclusion criteria. Of the included patients, 199 women received antibiotic-only treatment, and 41 received additional image-guided drainage. There was no statistically significant difference between the two groups in terms of age, body mass index, parity, incidence of diabetes, obesity, endometriosis, or history of sexually transmitted infection excluding human immunodeficiency virus (HIV). Abscesses in the drainage cohort were noted to be larger in dimension (5.9 cm vs. 8.5 cm); 16.1% of patients who received antibiotics alone required surgical intervention versus only 2.4% of the drainage cohort. Patients who received drainage had longer hospital stays, but the time from treatment to discharge was similar in both groups (7.4 days vs. 6.7 days). We successfully contacted 150 patients, and the differences in long-term pregnancy outcomes, pain, or infertility were not statistically significant.
  
  
  CONCLUSIONS
  Patients who received antibiotics alone were more likely to require further surgical intervention when compared with patients who additionally received image-guided drainage. There were no observable long-term differences.
authors: Department of Obstetrics and Gynecology and Women's Health, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York. Electronic address: juto@montefiore.org.
authors: Justin
authors: J
authors: To
authors: Department of Obstetrics and Gynecology and Women's Health, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.
authors: Diana
authors: D
authors: Aldape
authors: Department of Radiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.
authors: Andrei
authors: A
authors: Frost
authors: Department of Obstetrics and Gynecology and Women's Health, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.
authors: Gary L
authors: GL
authors: Goldberg
authors: Department of Obstetrics and Gynecology and Women's Health, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.
authors: Mark
authors: M
authors: Levie
authors: Department of Obstetrics and Gynecology and Women's Health, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.
authors: Scott
authors: S
authors: Chudnoff
mesh_terms: D000038:Abscess / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D004322:Drainage / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008875:Middle Aged; D010388:Pelvis; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013813:Therapy, Computer-Assisted / Q000379:methods*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antibiotics; drainage; long-term outcomes; pelvic abscess