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Current concepts in managing pelvic inflammatory disease

Judlin, Philippe

Current Opinion in Infectious Diseases: February 2010 - Volume 23 - Issue 1 - p 83–87
doi: 10.1097/QCO.0b013e328334de21
Sexually transmitted diseases and urinary tract infections Edited: by Anton L. Pozniak

Purpose of review The management of pelvic inflammatory disease (PID) has significantly changed during the last two decades. Moreover, some recent bacterial findings have led to recent changes in this management.

Recent findings Most cases of PID are mild-to-moderate uncomplicated forms that can be treated as outpatients. Apart from Chlamydia trachomatis and Neisseria gonorrhoeae, other pathogens such as Mycoplasma genitalium and bacterial vaginosis (BV)-associated bacteria are playing a significant role in PID and thus must be reckoned with. Moreover, gonococci have increasingly become resistant to the majority of antibiotics. This has led to a universal recommendation to treat N. gonorrhoeae infections with ceftriaxone. A few recent clinical trials have shown that quinolones and azithromycin (with metronidazole) are the best therapeutic options to treat uncomplicated PID.

Summary The management of PID nowadays must take into account the role of pathogens such as M. genitalium, BV-associated bacteria and multiresistant gonococci.

Department of Gynecology, Obstetrics & Reproduction, Maternite Regionale Universitaire of NANCY, Nancy, France

Correspondence to Philippe Judlin, MD, Chairman, Department of Gynecology, Obstetrics and Reproduction, Maternite Regionale Universitaire of NANCY, 10 rue du Dr Heydenreich, 54042 Nancy, France Tel: +33 383 34 4312; fax: +33 383 34 2924; e-mail:

© 2010 Lippincott Williams & Wilkins, Inc.