Management of uncomplicated pelvic inflammatory disease].

Service de gynécologie et obstétrique II et médecine de la reproduction, maternité de Port-Royal, groupe hospitalier Cochin - Broca - Hôtel-Dieu, hôpitaux universitaires Paris-Centre, 53, avenue de l'Observatoire, 75679 Paris cedex 14, France. antoine.bourret@cch.aphp.fr

Journal de gynécologie, obstétrique et biologie de la reproduction 2012 Dec

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Since the 1993 French consensus conference on uncomplicated pelvic inflammatory diseases (uPID), new antibiotics appeared and bacterial resistances did evoluate. This methodic analysis of the literature updates different aspects of its treatment. Antibiotherapy must be established early (EL3). Inpatient and intravenous treatment is not superior to outpatient and oral treatment (EL1). Ofloxacine+metronidazole association can be proposed in first intention (EL1). If case of Neisseria gonorrhoeae infection, one ceftriaxone injection must be associated (EL4). All the other antibiotics associations have shown to be efficient except the metronidazole+doxycycline association, which is not indicated (EL2). Two weeks treatment seems to be a sufficient duration. Laparoscopic treatment in first intention is not justified except for diagnostic doubts or unfavorable evolution of the medical treatment (EL4). Neither non-steroidic antiinflamatorries, nor corticosteroids, have been proved to be efficient to decrease the adherence risk in uPID (EL3). Early extraction of an intra uterine device (IUD) allows symptomatologic improvement (EL2). Partners treatment with azithromycin improves the 4 months bacteriologic results (EL2). HIV positive patients do not need specific treatment (EL3). Copyright © 2012. Published by Elsevier Masson SAS.

Citation

A Bourret, A Fauconnier, J-L Brun. Management of uncomplicated pelvic inflammatory disease]. Journal de gynécologie, obstétrique et biologie de la reproduction. 2012 Dec;41(8):864-74