Microbiology & Pathogenesis
- endometrial biopsy with histopathologic evidence of endometritis;
- transvaginal sonography or magnetic resonance imaging techniques showing thickened, fluid-filled tubes with or without free pelvic fluid or tubo-ovarian complex, or doppler studies suggesting pelvic infection (e.g., tubal hyperemia); and
- laparoscopic abnormalities consistent with PID.
Parenteral TreatmentRecommended Parenteral Regimen A
Cefotetan 2 g IV every 12 hours
Cefoxitin 2 g IV every 6 hours
Doxycycline 100 mg orally or IV every 12 hours
Recommmended Parenteral Regimen B
Clindamycin 900 mg IV every 8 hours
Gentamicin loading dose IV or IM (2 mg/kg of body weight), followed by a maintenance dose (1.5 mg/kg) every 8 hours. Single daily dosing may be substituted.
Alternative Parenteral Regimens
Recommended Regimen A
Levofloxacin 500 mg orally qd for 14 days*
Ofloxacin 400 mg bid for 14 days*
WITH OR WITHOUT
Metronidazole 500 mg orally bid for 14 days
Curr Infect Dis Rep.;2:501-505, 2000.