PID

Question 1

Outpatient treatment regime for PID

Answer 1

1) i.m. ceftriaxone* 500mg single dose followed by oral doxycycline 100mg twice daily plus
metronidazole 400mg twice daily for 14 days

2) oral ofloxacin 400mg twice daily plus oral metronidazole 400mg twice daily for 14 days
3) oral moxifloxacin 400mg once daily for 14 days

Question 2

A patient with mild PID is unable to tolerate metronidazole, what should you do?

Answer 2

Metronidazole is included in some regimens to improve coverage for anaerobic bacteria. Anaerobes
are of relatively greater importance in patients with severe PID and metronidazole may be discontinued in those patients with mild or moderate PID who are unable to tolerate it.

Question 3

What % of PID in the UK is GC related?

Answer 3

<3%

Question 4

Can you treat PID with doxycycline and metronidazole without cefriaxone n?

Answer 4

Ceftriaxone provides microbiological cover for N. gonorrhoeae but also other aerobic and anaerobic
bacteria associated with PID. The use of doxycycline plus metronidazole, in the absence of ceftriaxone, is not recommended because the evidence base is limited, previous trials have reported
significant rates of treatment failure and the addition of ceftriaxone improves treatment outcome.

Question 5

Inpatient treatment for PID

Answer 5

• i.v. ceftriaxone 2g daily plus i.v. doxycycline 100mg twice daily (oral doxycycline may be used
  if tolerated) followed by oral doxycycline 100mg twice daily plus oral metronidazole 400mg
  twice daily for a total of 14 days
• i.v. clindamycin 900mg 3 times daily plus i.v. gentamicin (2mg/kg loading dose)
  followed by 1.5mg/kg 3 times daily [a single daily dose of 7mg/kg may be substituted])
  followed by either oral clindamycin 450mg 4 times daily
  or oral doxycycline 100mg twice daily
  plus oral metronidazole 400mg twice daily to complete 14 days

Intravenous therapy should be continued until 24 hours after clinical improvement and then switched to
oral .

Question 6

When should someone with PID be reviewed?

Answer 6

At 72 hrs

Futehr review at 2-4 weeks

Question 7

Recommended test of cure for m.gen?

Answer 7

4 weeks

Question 8

What is the partner notification period for PID?

Answer 8

6 months

Question 9

What is the treatment of contacts of PID?

Answer 9

7 days doxycline