[Antibiotic therapy in the treatment of inflammatory diseases in the minor pelvis]. 1996

M Vasiljević, and A Marković, and R Ganović, and R Jovanović
Narodni Front Hospital of Gynaecology and Obstetrics, Belgrade.

Pelvic inflammatory diseases are usually caused by sexually transmitted microorganisms, as are Neisseria gonorrhoeae and Chlamydia trachomatis, either alone or associated with endogenous flora of the lower genital tract, as with other gram-positive and gram-negative anaerobic and aerobic bacteria [1, 2]. METHODS The aim of the study was to estimate the effect of three broad-spectrum combinations of antimicrobial therapy in the treatment of pelvic inflammatory diseases in hospitalized patients. METHODS We analysed the therapeutic success of some antimicrobial therapies in 154 patients with pelvic inflammatory disease, who were treated in the Narodni Front Hospital of Gynaecology and Obstetrics in Belgrade, during 1992 and 1993. Three drug therapies were applied. The combination of Ceftriaxon plus Doxycycline was given to 51 women. Fifty five women were treated by a combination of Gentamycin plus Clidamycin, and 48 women were treated by a combination of Gentamycin and Metronidazole. RESULTS The therapeutic success after the application of the three different antibiotic therapies was recorded in 139 of 154 women (90.26%). Of 136 patients with uncomplicated pelvic inflammatory diseases, the therapeutic success was noted in 129 (94.85%) individuals, while of 18 women with tubo-ovarian abscess therapeutic success was recorded in 10 (55.56%) patients. Of 51 women treated by the combination of Ceftriaxon plus Doxycycline, the therapeutic success was observed in 46 (90.19%) patients. Fifty five women treated by the combination of Gentamycin plus Clindamycin, the therapeutic success was noted in 50 (90.19%) subjects. Of 48 women, treated by the combination of Gentamycin plus Metronidazole, the therapeutic success was found in 43 (89.58%) women. No statistically significant difference was found among the applied antibiotic therapies (p > 0.05). Of 18 women with tubo-ovarian abscess 8 were operated on. Of these 8 women in 6 patients hysterectomy with bilateral salpingo-oophorectomy was performed and in two women unilateral salpingo-oophorectomy was carried out. CONCLUSIONS Pelvic inflammatory diseases are often of polymicrobial aetiology. In 43 patients we found two types of bacteria in the cervical culture. The therapeutic success was achieved by these three antibiotic therapies. It was 90.26%, the therapeutic success in the treatment of pelvic inflammatory diseases by Ceftriaxon plus Doxycycline was noted in 90.19% of patients. The therapeutic success of antibiotic therapy with Gentamycin plus Clindamycin was obtained in 90.91% of patients. The success of antibiotic therapy with Gentamycin plus Metronidazole was recorded in 89.59% of patients. Our results are similar to those of other authors [3, 4, 6, 7]. No statistically significant difference was found among the applied antibiotic therapies. CONCLUSIONS An early diagnosis and an aggressive treatment may prevent serious sequelae of this increasingly common sexually transmitted disease. The antibiotics should be of antimicrobial broad spectrum. Good effects can be best reached by a combined antibiotic therapy. Duration of parenteral administration of antibiotics should be several days and for at least 48 hours after the patient's defervescence.

UI MeSH Term Description Entries
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D004359 Drug Therapy, Combination Therapy with two or more separate preparations given for a combined effect. Combination Chemotherapy,Polychemotherapy,Chemotherapy, Combination,Combination Drug Therapy,Drug Polytherapy,Therapy, Combination Drug,Chemotherapies, Combination,Combination Chemotherapies,Combination Drug Therapies,Drug Polytherapies,Drug Therapies, Combination,Polychemotherapies,Polytherapies, Drug,Polytherapy, Drug,Therapies, Combination Drug
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000292 Pelvic Inflammatory Disease A spectrum of inflammation involving the female upper genital tract and the supporting tissues. It is usually caused by an ascending infection of organisms from the endocervix. Infection may be confined to the uterus (ENDOMETRITIS), the FALLOPIAN TUBES; (SALPINGITIS); the ovaries (OOPHORITIS), the supporting ligaments (PARAMETRITIS), or may involve several of the above uterine appendages. Such inflammation can lead to functional impairment and infertility. Adnexitis,Inflammatory Disease, Pelvic,Inflammatory Pelvic Disease,Pelvic Disease, Inflammatory,Disease, Inflammatory Pelvic,Disease, Pelvic Inflammatory,Diseases, Inflammatory Pelvic,Diseases, Pelvic Inflammatory,Inflammatory Diseases, Pelvic,Inflammatory Pelvic Diseases,Pelvic Diseases, Inflammatory,Pelvic Inflammatory Diseases
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000900 Anti-Bacterial Agents Substances that inhibit the growth or reproduction of BACTERIA. Anti-Bacterial Agent,Anti-Bacterial Compound,Anti-Mycobacterial Agent,Antibacterial Agent,Antibiotics,Antimycobacterial Agent,Bacteriocidal Agent,Bacteriocide,Anti-Bacterial Compounds,Anti-Mycobacterial Agents,Antibacterial Agents,Antibiotic,Antimycobacterial Agents,Bacteriocidal Agents,Bacteriocides,Agent, Anti-Bacterial,Agent, Anti-Mycobacterial,Agent, Antibacterial,Agent, Antimycobacterial,Agent, Bacteriocidal,Agents, Anti-Bacterial,Agents, Anti-Mycobacterial,Agents, Antibacterial,Agents, Antimycobacterial,Agents, Bacteriocidal,Anti Bacterial Agent,Anti Bacterial Agents,Anti Bacterial Compound,Anti Bacterial Compounds,Anti Mycobacterial Agent,Anti Mycobacterial Agents,Compound, Anti-Bacterial,Compounds, Anti-Bacterial
D001424 Bacterial Infections Infections by bacteria, general or unspecified. Bacterial Disease,Bacterial Infection,Infection, Bacterial,Infections, Bacterial,Bacterial Diseases
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective

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