Pelvic_Inflammatory_Disease_Flashcards
When should urgent hospital admission be considered for pelvic inflammatory disease (PID)?
Urgent hospital admission should be considered for PID if there are severe systemic symptoms, signs of complications, or suspicion of pregnancy.
What should be done if an intrauterine device (IUD) is in situ in a patient with PID?
If an IUD is in situ in a patient with PID, consider removal, usually if the patient has failed to respond to treatment after 72 hours.
What is the outpatient antibiotic regimen for PID?
The outpatient antibiotic regimen for PID includes ceftriaxone 1g IM (single dose), doxycycline 100 mg BD (oral) for 14 days, and metronidazole 400 mg BD (oral) for 14 days.
What is an alternative antibiotic regimen for PID?
An alternative antibiotic regimen for PID is ofloxacin plus metronidazole for 14 days.
What is the first-line treatment if the patient is pyrexial or oral management has failed?
The first-line treatment if the patient is pyrexial or oral management has failed is IV cefoxitin plus doxycycline.
What is the second-line treatment if the patient is pyrexial or oral management has failed?
The second-line treatment if the patient is pyrexial or oral management has failed is IV clindamycin plus gentamicin.
What STI screenings should be offered to patients with PID?
STI screenings for chlamydia and gonorrhoea should be offered to patients with PID, ideally before starting antibiotic treatment.
What should be done for current and recent partners of patients with PID?
Current and recent partners (within the last 6 months) of patients with PID should be contacted and offered advice, screening, and treatment.
What advice should be given regarding contraception for patients with PID?
Patients with PID should be advised about barrier contraception.
What follow-up care is recommended for patients with PID managed as outpatients?
Patients with PID managed as outpatients should be seen within 72 hours to assess response. If there is no improvement, they should be admitted for IV antibiotics. Further follow-up at 2-4 weeks is recommended to ensure resolution, reiterate the importance of STIs, and reassure that if compliant, fertility is not affected.
What are the complications of PID?
Complications of PID include infertility, ectopic pregnancy, and chronic pelvic pain.
What risk factors should be considered for PID?
Risk factors for PID include being younger (< 25 years), having an STI, multiple sexual partners, and a history of past PID.
How should the diagnosis of PID be explained to patients?
The diagnosis of PID should be explained as an infection that has spread up to the womb.
What are the risks of PID that should be communicated to patients?
The risks of PID that should be communicated to patients include infertility, ectopic pregnancy, and chronic pelvic pain.
What is the recommended antibiotic treatment plan for PID?
The recommended antibiotic treatment plan for PID is one injection and two tablets taken for 14 days.
