Combination antimicrobial therapy in the treatment of acute pelvic inflammatory disease

Article Abstract:

Many bacteria can cause pelvic inflammatory disease, and it is possible that multiple species may be responsible for the disease in an individual. In these cases, a single type of antibiotic may not be effective, and combination antimicrobial therapy has been recommended. However, although several regimens have been used, their effectiveness in actual medical practice has not been well-studied. The effectiveness of cefoxitin plus doxycycline was compared with that of clindamycin plus tobramycin in the treatment of pelvic inflammatory disease in 148 women. All antibiotics were administered for a minimum of four days intravenously, and upon discharge from the hospital, a regimen of oral medication was continued for two weeks. An initial satisfactory response to the antibiotics occurred in 97 percent of patients, and response was not different between those with uncomplicated disease and those with abscesses. Neisseria gonorrhoeae and Chlamydia trachomatis (C. trachomatis) were the bacteria most often isolated from patients. C. trachomatis can be especially difficult to remove, and the clindamycin regimen appeared to be more effective in treating this bacterial infection. Mild nausea or diarrhea were the most common side effects of treatment. The results indicate that either regimen is effective and safe in the short-term treatment of pelvic inflammatory disease; the long-term effectiveness of such treatment remains to be determined. (Consumer Summary produced by Reliance Medical Information, Inc.)

Anti-infective agents, Drug therapy, Pelvic inflammatory disease

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Randomized treatment of mucopurulent cervicitis with doxycycline or amoxicillin

Article Abstract:

A study of 64 patients was conducted to determine the treatment for Mucopurulent cervicitis, the inflammation of the cervix with a mucous discharge. Forty-seven percent of the subjects were found to have the condition due to an organisms such as Chlamydia trachomatis, while 8% had the condition as a result of Neisseria gonorrhea. Both are sexually transmitted diseases. Treatment is necessary to prevent pelvic infections. However, half of patients with this type of cervicitis have neither of these infections and the cause is unknown. Treatment with two types of antibiotics, doxycycline and amoxicillin, was successful in both chlamydia and nonchlamydia cervicitis. Purulent discharge was still evident, however, among the subjects after two months (18 percent) and three months (doxycycline 23 percent, amoxicillin 33 percent). No other identifiable infection was responsible for the recurring or persistent discharge.

Care and treatment, Chlamydia trachomatis, Neisseria gonorrhoeae, Doxycycline, Cervicitis, Amoxicillin

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Determinants of cervical ectopia and of cervicitis: age, oral contraception, specific cervical infection, smoking, and douching

Article Abstract:

Certain factors are associated with cervical ectopia and cervicitis. Cervical ectopia is the growth of cells lining the inner cervix over the outer cervix, and cervicitis is inflammation of the cervix. Two groups of women were evaluated to determine what factors are associated with the two conditions: 764 patients at a clinic for sexually transmitted diseases and 819 college students having a regular annual gynecologic examination. Overall, younger age, use of oral contraception, and current infection with Chlamydia trachomatis were associated with cervical ectopia. Among STD patients, cytomegalovirus infection and white race were associated with ectopia. Overall, cervicitis was associated with infection and ectopia. Swelling and redness were associated with contraceptive use. Ectopia may predispose to infection because the cells lining the inner cervix are more vulnerable to injury and infection.

Health aspects, Complications and side effects, Oral contraceptives, Chlamydia infections

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