Treatments for Pelvic Inflammatory Disease


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Treatment list for Pelvic Inflammatory Disease: The list of treatments mentioned in various sources for Pelvic Inflammatory Disease includes the following list. Always seek professional medical advice about any treatment or change in treatment plans.

Treatment of Pelvic Inflammatory Disease: medical news summaries: The following medical news items are relevant to treatment of Pelvic Inflammatory Disease:

Treatments of Pelvic Inflammatory Disease discussion: PID can be cured with antibiotics. If women have pelvic pain and other symptoms caused by PID, it is critical that they seek care immediately. Prompt antibiotic treatment can prevent severe damage to pelvic organs. The longer women delay treatment for PID, the more likely they are to be infertile or to have an ectopic pregnancy in the future because of damage to the tubes. However, antibiotic treatment does not reverse any damage that has already occurred to the reproductive organs.

Because of the difficulty in identifying organisms infecting the internal reproductive organs and because more than one organism may be responsible for an episode of PID, PID is usually treated with at least two antibiotics that are effective against a wide range of infectious agents. These antibiotics can be given by mouth or by vein. The symptoms may go away before the infection is cured. Even if symptoms do go away, women should finish taking all of the medicine. This will help prevent the infection from returning. Women on treatment for PID should be re-evaluated by their health care provider two to three days after starting treatment to be sure the antibiotics are working to cure the infection. In addition, women's sex partners should be treated to decrease the risk of re-infection, even if the partners have no symptoms. Many women with PID have sex partners who have no symptoms, although their sex partners may be infected with the organisms that can cause PID.

About one fourth of women with suspected PID must be hospitalized. Hospitalization may be recommended if the woman is severely ill (e.g., high fever) or pregnant; if she cannot take oral medication and needs intravenous antibiotics; if the diagnosis is uncertain; or in some cases, if she is infected with HIV (human immunodeficiency virus, the virus that causes AIDS). If symptoms continue or if an abscess does not resolve, surgery may be needed. Complications of PID, such as chronic pelvic pain and scarring are difficult to treat but are sometimes improved with surgery.1

Because culture of specimens from the upper genital tract are difficult to obtain and because multiple organisms may be responsible for an episode of PID, especially if it is not the first one, the doctor will prescribe at least two antibiotics that are effective against a wide range of infectious agents. The symptoms may go away before the infection is cured. Even if symptoms do go away, patients should finish taking all of the medicine. Patients should be re-evaluated by their physicians two to three days after treatment is begun to be sure the antibiotics are working to cure the infection.

About one-fourth of women with suspected PID must be hospitalized. The doctor may recommend this if the patient is severely ill; if she cannot take oral medication and needs intravenous antibiotics; if she is pregnant or is an adolescent; if the diagnosis is uncertain and may include an abdominal emergency such as appendicitis; or if she is infected with HIV (human immunodeficiency virus, the virus that causes AIDS).

Many women with PID have sex partners who have no symptoms, although their sex partners may be infected with organisms that can cause PID. Because of the risk of reinfection, however, sex partners should be treated even if they do not have symptoms.

Consequences of PID

Women with recurrent episodes of PID are more likely than women with a single episode to suffer scarring of the tubes that leads to infertility, tubal pregnancy, or chronic pelvic pain. Infertility occurs in approximately 20 percent of women who have had PID.

Most women with tubal infertility, however, never have had symptoms of PID. Organisms such as C. trachomatis can silently invade the fallopian tubes and cause scarring, which blocks the normal passage of eggs into the uterus.

A women who has had PID has a six-to-tenfold increased risk of tubal pregnancy, in which the egg can become fertilized but cannot pass into the uterus to grow. Instead, the egg usually attaches in the fallopian tube, which connects the ovary to the uterus. The fertilized egg cannot grow normally in the fallopian tube. This type of pregnancy is life-threatening to the mother, and almost always fatal to her fetus. It is the leading cause of pregnancy-related death in African-American women.

In addition, untreated PID can cause chronic pelvic pain and scarring in about 20 percent of patients. These conditions are difficult to treat but are sometimes improved with surgery.

Another complication of PID is the risk of repeated attacks of PID. As many as one-third of women who have had PID will have the disease at least one more time. With each episode of reinfection, the risk of infertility is increased.

Prevention

Women can play an active role in protecting themselves from PID by taking the following steps:

  • Signs of discharge with odor or bleeding between cycles could mean infection. Early treatment may prevent the development of PID.
  • If used correctly and consistently, male latex condoms will prevent transmission of gonorrhea and partially protect against chlamydial infection.

Research

Although much has been learned about the biology of the microbes that cause PID and the ways in which they damage the body, there is still much to learn. Scientists supported by the National Institute of Allergy and Infectious Diseases (NIAID) are studying the effects of antibiotics, hormones, and substances that boost the immune system. These studies may lead to insights about how to prevent infertility or other complications of PID. Topical microbicides and vaccines to prevent gonorrhea and chlamydial infection also are being developed. Clinical trials are in progress to test a suppository containing lactobacilli the normal bacteria found in the vaginas of healthy women. These bacteria colonize the vagina and may be associated with reduced risk of gonorrhea and bacterial vaginosis, both of which can cause PID.

Rapid, inexpensive, easy-to-use diagnostic tests are being developed to detect chlamydial infection and gonorrhea. A recent study conducted by NIAID-funded researchers demonstrated that screening and treating women who unknowingly had chlamydial infection reduced cases of PID by more than 60 percent. Meanwhile, researchers continue to search for better ways to detect PID itself, particularly in women with "silent" or asymptomatic PID.

2

Because culture specimens from the upper genital tract are difficult to obtain and because multiple organisms are usually responsible for an episode of PID, at least two antibiotics are given so that they will be effective against a wide range of infectious agents. The infection may still be present after the symptoms are gone, so it is important to finish taking all of the medicine, even if symptoms go away. Patients should be re-evaluated by their physician 2 to 3 days after treatment is begun to be sure the antibiotics are working to cure the infection. About one-fourth of women with suspected PID must be hospitalized.

Many women with PID have sex partners who have no symptoms. Because of the risk of reinfection, however, sex partners should be treated. Even if they do not have symptoms, they may be infected with organisms that can cause PID. 3

Footnotes:
1. excerpt from PID: DSTD
2. excerpt from Pelvic Inflammatory Disease, NIAID Fact Sheet: NIAID
3. excerpt from Pelvic Inflammatory Disease: NWHIC

Last revision: June 10, 2003

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