Skip Navigation Links
Centers for Disease Control and Prevention
 CDC Home Search Health Topics A-Z
National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention
  Division of Sexually Transmitted Diseases
    Program and Training Branch
STD Prevention STD Training Home Links Contact Us Glossary 
STD Prevention
Self-Study Modules
Pelvic Inflammatory Disease (PID)
Course Objective
Line separator
Target audience
Line separator
Continuing education
Lessons
Line separator
Epidemiology
Line separator
Pathogenesis and microbiology
Line separator
Clinical manifestations and sequelae
Line separator
Diagnostic methods
Line separator
Patient management / treatment
Line separator
Patient counseling and education
Line separator
Partner management / Public health
Line separator
Case study
Line separator
Resources
Line separator
 

Self-Study STD Module - PID

Patient Management/Treatment (continued)

The current CDC recommendations for the treatment of PID include both oral and parenteral regimens.

Oral Regimens

Each of the following oral regimens should be continued for a total of 14 days. Patients on oral therapy ideally should be followed up within 72 hours, at which time they should show substantial clinical improvement. If no improvement occurs, the patient should be re-evaluated to confirm the diagnosis and should be switched to parenteral therapy either in an outpatient or inpatient setting. The addition of metronidazole should be considered, as anaerobic organisms are suspected in the etiology of the majority of cases. Metronidazole will also treat BV, which frequently is associated with PID.

Oral Regimen A
Ceftriaxone 250 mg IM in a single dose
PLUS
Doxycycline 100 mg orally 2 times a day for 14 days
With or Without
Metronidazole 500 mg orally 2 times a day for 14 days
Oral Regimen B
Cefoxitin 2 g IM in a single dose and Probenecid 1 g orally administered concurrently in a single dose
PLUS
Doxycycline 100 mg orally 2 times a day for 14 days
With or Without
Metronidazole 500 mg orally 2 times a day for 14 days
Oral Regimen C
Other parenteral third-generation cephalosporin (e.g., ceftizoxime, cefotaxime)
PLUS
Doxycycline 100 mg orally 2 times a day for 14 days
With or Without
Metronidazole 500 mg orally 2 times a day for 14 days

Click here for a Study Question

Follow Up

Patients should be re-examined within 72 hours after initiation of therapy and should demonstrate substantial clinical improvement (i.e., defervescence; reduction in rebound or direct abdominal tenderness; reduction in uterine, adnexal, and cervical motion tenderness). Patients who do not improve usually require hospitalization, additional diagnostic tests, and possible surgical intervention.

Some experts recommend rescreening for C. trachomatis and N. gonorrhoeae after therapy, in women with documented infection due to these pathogens. The optimal time period for rescreening is 4-6 weeks.  All women diagnosed with acute PID should be offered HIV testing.

Page 7 of 13 BackStatusStatusNext



Page last modified: June 3, 2009
Page last reviewed: June 3, 2009

Content Source: Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention


STD Home
| STD Index

CDC Home | Search | Health Topics A-Z

Centers for Disease Control and Prevention
National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention
     Division of Sexually Transmitted Diseases Prevention