Template:PID antibiotics: Difference between revisions

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****History of gynecological instrumentation in the preceding 2-3wks
****History of gynecological instrumentation in the preceding 2-3wks
*[[Cefoxitin]] 2 g IM in a single dose and Probenecid, 1 g PO administered concurrently in a single dose<ref>CDC PID Treatment http://www.cdc.gov/std/treatment/2010/pid.htm</ref> + [[Doxycycline]] 100 mg PO BID x 14 days +/- [[flagyl]] based on above criteria
*[[Cefoxitin]] 2 g IM in a single dose and Probenecid, 1 g PO administered concurrently in a single dose<ref>CDC PID Treatment http://www.cdc.gov/std/treatment/2010/pid.htm</ref> + [[Doxycycline]] 100 mg PO BID x 14 days +/- [[flagyl]] based on above criteria
=====Discontinued=====
*Historically the following regimens were acceptable but with the emerging resistance patterns use the following with caution.<ref>Update to CDC's Treatment Guidelines for Gonococcal Infection, 2020 https://www.cdc.gov/mmwr/volumes/69/wr/mm6950a6.htm </ref>
*[[Ceftriaxone]] 250mg IM x1 + 1 g of [[azithromycin]] per week, x 2 weeks<ref name="Savaris">Savaris RF. et al. Comparing ceftriaxone plus azithromycin or doxycycline for pelvic inflammatory disease: a randomized controlled trial. Obstet Gynecol. 2007 Jul;110(1):53-60</ref> +/- [[metronidazole]] based on above criteria
**A single randomized controlled trial shows that [[azithromycin]] is superior to [[doxycycline]] even when compliance in taking doxycycline is excellent (98.2% vs 87.5%)<ref name="Savaris"></ref>


==== Inpatient Antibiotic Options ====
==== Inpatient Antibiotic Options ====

Revision as of 16:55, 27 May 2021

Antibiotics

  • No sexual activity for 2 weeks;
  • Treat all partners who had sex with patient during previous 60 days prior to symptom onset

Outpatient Antibiotic Options

Inpatient Antibiotic Options

  1. Hayes BD. Trick of the Trade: IV ceftriaxone for gonorrhea. October 9th, 2012 ALiEM. https://www.aliem.com/2012/10/trick-of-trade-iv-ceftriaxone-for/. Accessed October 23, 2018.
  2. Update to CDC's Treatment Guidelines for Gonococcal Infection, 2020 https://www.cdc.gov/mmwr/volumes/69/wr/mm6950a6.htm
  3. Ness RB et al. Effectiveness of inpatient and outpatient treatment strategies for women with pelvic inflammatory disease: results from the Pelvic Inflammatory Disease Evaluation and Clinical Health (PEACH) Randomized Trial. Am J Obstet Gynecol 2002;186:929–37
  4. Ross J, Guaschino S, Cusini M, Jensen J, 2017 European guideline for the management of pelvic inflammatory disease. Int J STD AIDS. 2018 Feb;29(2):108-114. doi: 10.1177/0956462417744099. Epub 2017 Dec 4.
  5. CDC PID Treatment http://www.cdc.gov/std/treatment/2010/pid.htm