Pelvic inflammatory disease: Current concepts in pathogenesis, diagnosis and treatment

Infectious Disease Clinics of North America

Volumn 27, Issue 4, 2013, Pages 793-809

  Mitchell, Caroline ^a   Prabhu, Malavika ^a  

^a UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE   (United States)

Author keywords

Cervical infection; Chlamydia trachomatis; Neisseria gonorrhoeae; Pelvic inflammatory disease

Indexed keywords

AMOXICILLIN; AMPICILLIN; AZITHROMYCIN; CEFOTAXIME; CEFOTETAN; CEFOXITIN; CEFTRIAXONE; CEPHALOSPORIN; CLINDAMYCIN; CONTRACEPTIVE AGENT; DOXYCYCLINE; GENTAMICIN; METRONIDAZOLE; MOXIFLOXACIN; PROBENECID; SULBACTAM; TETRACYCLINE;

ABDOMINAL PAIN; ABNORMAL LABORATORY RESULT; ABSCESS DRAINAGE; AGE; ANTIMICROBIAL THERAPY; ATOPOBIUM VAGINAE; BACTERIAL GENE; BACTERIUM DETECTION; CHLAMYDIA TRACHOMATIS; CHLAMYDIASIS; CLINICAL FEATURE; CONCURRENT SEXUAL PARTNERSHIP; DIAGNOSTIC PROCEDURE; DIFFERENTIAL DIAGNOSIS; DISEASE TRANSMISSION; DRUG BIOAVAILABILITY; DRUG EFFICACY; DRUG INDICATION; DRUG TOLERABILITY; DRUG TREATMENT FAILURE; DRUG USE; ECHOGRAPHY; ECTOPIC PREGNANCY; ENDOMETRITIS; ERYTHROCYTE SEDIMENTATION RATE; FEMALE; FEMALE GENITAL SYSTEM; FEMALE INFERTILITY; GASTROINTESTINAL SYMPTOM; GONORRHEA; HISTOPATHOLOGY; HIV TEST; HUMAN; HUMAN IMMUNODEFICIENCY VIRUS INFECTED PATIENT; IMMUNOSUPPRESSIVE TREATMENT; INTRAUTERINE CONTRACEPTIVE DEVICE; LAPAROSCOPY; LEPTOTRICHIA; LEUKOCYTE COUNT; LEUKORRHEA; LEVONORGESTREL RELEASING INTRAUTERINE SYSTEM; MAINTENANCE THERAPY; MEDICATION COMPLIANCE; MENSTRUAL IRREGULARITY; MIXED INFECTION; MONOTHERAPY; MYCOPLASMA GENITALIUM; NEISSERIA GONORRHOEAE; NONHUMAN; ORAL CONTRACEPTIVE USE; PATHOGENESIS; PELVIC INFLAMMATORY DISEASE; PELVIC PAIN; PEPTOSTREPTOCOCCUS; PHLEBITIS; POLYMERASE CHAIN REACTION; POSTMENOPAUSE; POSTMENOPAUSE BLEEDING; PREVALENCE; PREVOTELLA; REVIEW; RISK FACTOR; SALPINGITIS; SCREENING TEST; SENSITIVITY AND SPECIFICITY; SEXUALLY TRANSMITTED DISEASE; SMOKING; TUBOOVARIAN ABSCESS; VAGINA BLEEDING; VAGINA DISCHARGE; VAGINAL LAVAGE; VAGINAL SPECULUM; VAGINITIS;

CERVICAL INFECTION; CHLAMYDIA TRACHOMATIS; NEISSERIA GONORRHOEAE; PELVIC INFLAMMATORY DISEASE;

ANTI-BACTERIAL AGENTS; BACTERIAL INFECTIONS; EARLY DIAGNOSIS; FEMALE; HUMANS; PELVIC INFLAMMATORY DISEASE; SEXUALLY TRANSMITTED DISEASES;

EID: 84888037268     PISSN: 08915520     EISSN: 15579824     Source Type: Journal    
DOI: 10.1016/j.idc.2013.08.004     Document Type: Review

References (107)

1. Rein D.B., Kassler W.J., Irwin K.L., et al. Direct medical cost of pelvic inflammatory disease and its sequelae: decreasing, but still substantial. Obstet Gynecol 2000, 95(3):397-402.
2. Bender N., Herrmann B., Andersen B., et al. Chlamydia infection, pelvic inflammatory disease, ectopic pregnancy and infertility: cross-national study. Sex Transm Infect 2011, 87(7):601-608.
3. Paik C.K., Waetjen L.E., Xing G., et al. Hospitalizations for pelvic inflammatory disease and tuboovarian abscess. Obstet Gynecol 2006, 107(3):611-616.
4. Sutton M.Y., Sternberg M., Zaidi A., et al. Trends in pelvic inflammatory disease hospital discharges and ambulatory visits, United States, 1985-2001. Sex Transm Dis 2005, 32(12):778-784.
5. Owusu-Edusei K., Bohm M.K., Chesson H.W., et al. Chlamydia screening and pelvic inflammatory disease: insights from exploratory time-series analyses. Am J Prev Med 2010, 38(6):652-657.
6. Bohm M.K., Newman L., Satterwhite C.L., et al. Pelvic inflammatory disease among privately insured women, United States, 2001-2005. Sex Transm Dis 2010, 37(3):131-136.
7. Ness R.B., Soper D.E., Holley R.L., et al. Hormonal and barrier contraception and risk of upper genital tract disease in the PID Evaluation and Clinical Health (PEACH) study. Am J Obstet Gynecol 2001, 185(1):121-127.
8. Ness R.B., Soper D.E., Holley R.L., et al. Douching and endometritis: results from the PID Evaluation and Clinical Health (PEACH) study. Sex Transm Dis 2001, 28(4):240-245.
9. Simms I., Stephenson J.M., Mallinson H., et al. Risk factors associated with pelvic inflammatory disease. Sex Transm Infect 2006, 82(6):452-457.
10. Scholes D., Daling J.R., Stergachis A., et al. Vaginal douching as a risk factor for acute pelvic inflammatory disease. Obstet Gynecol 1993, 81(4):601-606.
11. Wolner-Hanssen P., Eschenbach D.A., Paavonen J., et al. Association between vaginal douching and acute pelvic inflammatory disease. JAMA 1990, 263(14):1936-1941.
12. Kimani J., Maclean I.W., Bwayo J.J., et al. Risk factors for Chlamydia trachomatis pelvic inflammatory disease among sex workers in Nairobi, Kenya. JInfect Dis 1996, 173(6):1437-1444.
13. Ness R.B., Keder L.M., Soper D.E., et al. Oral contraception and the recognition of endometritis. Am J Obstet Gynecol 1997, 176(3):580-585.
14. Wolner-Hanssen P., Svensson L., Mardh P.A., et al. Laparoscopic findings and contraceptive use in women with signs and symptoms suggestive of acute salpingitis. Obstet Gynecol 1985, 66(2):233-238.
15. Taylor B.D., Darville T., Haggerty C.L. Does bacterial vaginosis cause pelvic inflammatory disease?. Sex Transm Dis 2013, 40(2):117-122.
16. Ness R.B., Hillier S.L., Kip K.E., et al. Bacterial vaginosis and risk of pelvic inflammatory disease. Obstet Gynecol 2004, 104(4):761-769.
17. Eschenbach D.A., Buchanan T.M., Pollock H.M., et al. Polymicrobial etiology of acute pelvic inflammatory disease. NEngl J Med 1975, 293(4):166-171.
18. Sweet R.L. Pelvic inflammatory disease. Sex Transm Dis 1986, 13(Suppl 3):192-198.
19. Taylor B.D., Ness R.B., Darville T., et al. Microbial correlates of delayed care for pelvic inflammatory disease. Sex Transm Dis 2011, 38(5):434-438.
20. Haggerty C.L., Totten P.A., Astete S.G., et al. Mycoplasma genitalium among women with nongonococcal, nonchlamydial pelvic inflammatory disease. Infect Dis Obstet Gynecol 2006, 2006:30184.
21. Westrom L., Joesoef R., Reynolds G., et al. Pelvic inflammatory disease and fertility. A cohort study of 1,844 women with laparoscopically verified disease and 657 control women with normal laparoscopic results. Sex Transm Dis 1992, 19(4):185-192.
22. Heinonen P.K., Miettinen A. Laparoscopic study on the microbiology and severity of acute pelvic inflammatory disease. Eur J Obstet Gynecol Reprod Biol 1994, 57(2):85-89.
23. Hillier S.L., Kiviat N.B., Hawes S.E., et al. Role of bacterial vaginosis-associated microorganisms in endometritis. Am J Obstet Gynecol 1996, 175(2):435-441.
24. Taylor-Robinson D., Jensen J.S., Svenstrup H., et al. Difficulties experienced in defining the microbial cause of pelvic inflammatory disease. Int J STD AIDS 2012, 23(1):18-24.
25. Bjartling C., Osser S., Persson K. Mycoplasma genitalium in cervicitis and pelvic inflammatory disease among women at a gynecologic outpatient service. Am J Obstet Gynecol 2012, 206(6):476.e1-476.e8.
26. Cohen C.R., Manhart L.E., Bukusi E.A., et al. Association between Mycoplasma genitalium and acute endometritis. Lancet 2002, 359(9308):765-766.
27. Soper D.E., Brockwell N.J., Dalton H.P., et al. Observations concerning the microbial etiology of acute salpingitis. Am J Obstet Gynecol 1994, 170(4):1008-1014. [discussion: 14-7].
28. Wasserheit J.N., Bell T.A., Kiviat N.B., et al. Microbial causes of proven pelvic inflammatory disease and efficacy of clindamycin and tobramycin. Ann Intern Med 1986, 104(2):187-193.
29. Hebb J.K., Cohen C.R., Astete S.G., et al. Detection of novel organisms associated with salpingitis, by use of 16S rRNA polymerase chain reaction. JInfect Dis 2004, 190(12):2109-2120.
30. Herzog S.A., Althaus C.L., Heijne J.C., et al. Timing of progression from Chlamydia trachomatis infection to pelvic inflammatory disease: a mathematical modelling study. BMC Infect Dis 2012, 12:187.
31. Morre S.A., van den Brule A.J., Rozendaal L., et al. The natural course of asymptomatic Chlamydia trachomatis infections: 45% clearance and no development of clinical PID after one-year follow-up. Int J STD AIDS 2002, 13(Suppl 2):12-18.
32. Oakeshott P., Kerry S., Aghaizu A., et al. Randomised controlled trial of screening for Chlamydia trachomatis to prevent pelvic inflammatory disease: the POPI (Prevention of Pelvic Infection) trial. BMJ 2010, 340:c1642.
33. Katz D.F. Human cervical mucus: research update. Am J Obstet Gynecol 1991, 165(6 Pt 2):1984-1986.
34. Kunz G., Beil D., Deininger H., et al. The dynamics of rapid sperm transport through the female genital tract: evidence from vaginal sonography of uterine peristalsis and hysterosalpingoscintigraphy. Hum Reprod 1996, 11(3):627-632.
35. Darville T., Hiltke T.J. Pathogenesis of genital tract disease due to Chlamydia trachomatis. JInfect Dis 2010, 201(Suppl 2):S114-S125.
36. Patton D.L., Kuo C.C. Histopathology of Chlamydia trachomatis salpingitis after primary and repeated reinfections in the monkey subcutaneous pocket model. JReprod Fertil 1989, 85(2):647-656.
37. Van Voorhis W.C., Barrett L.K., Sweeney Y.T., et al. Repeated Chlamydia trachomatis infection of Macaca nemestrina fallopian tubes produces a th1-like cytokine response associated with fibrosis and scarring. Infect Immun 1997, 65(6):2175-2182.
38. Peeling R.W., Kimani J., Plummer F., et al. Antibody to chlamydial hsp60 predicts an increased risk for chlamydial pelvic inflammatory disease. JInfect Dis 1997, 175(5):1153-1158.
39. Toye B., Laferriere C., Claman P., et al. Association between antibody to the chlamydial heat-shock protein and tubal infertility. JInfect Dis 1993, 168(5):1236-1240.
40. Ness R.B., Soper D.E., Richter H.E., et al. Chlamydia antibodies, chlamydia heat shock protein, and adverse sequelae after pelvic inflammatory disease: the PID Evaluation and Clinical Health (PEACH) study. Sex Transm Dis 2008, 35(2):129-135.
41. Kiviat N.B., Wolner-Hanssen P., Eschenbach D.A., et al. Endometrial histopathology in patients with culture-proved upper genital tract infection and laparoscopically diagnosed acute salpingitis. Am J Surg Pathol 1990, 14(2):167-175.
42. Haggerty C.L., Ness R.B., Amortegui A., et al. Endometritis does not predict reproductive morbidity after pelvic inflammatory disease. Am J Obstet Gynecol 2003, 188(1):141-148.
43. Achilles S.L., Amortegui A.J., Wiesenfeld H.C. Endometrial plasma cells: do they indicate subclinical pelvic inflammatory disease?. Sex Transm Dis 2005, 32(3):185-188.
44. Wiesenfeld H.C., Hillier S.L., Meyn L.A., et al. Subclinical pelvic inflammatory disease and infertility. Obstet Gynecol 2012, 120(1):37-43.
45. Jacobson L. Differential diagnosis of acute pelvic inflammatory disease. Am J Obstet Gynecol 1980, 138(7 Pt 2):1006-1011.
46. Short V.L., Totten P.A., Ness R.B., et al. Clinical presentation of Mycoplasma genitalium infection versus Neisseria gonorrhoeae infection among women with pelvic inflammatory disease. Clin Infect Dis 2009, 48(1):41-47.
47. Jacobson L., Westrom L. Objectivized diagnosis of acute pelvic inflammatory disease. Diagnostic and prognostic value of routine laparoscopy. Am J Obstet Gynecol 1969, 105(7):1088-1098.
48. Simms I., Eastick K., Mallinson H., et al. Associations between Mycoplasma genitalium, Chlamydia trachomatis, and pelvic inflammatory disease. Sex Transm Infect 2003, 79(2):154-156.
49. Eckert L.O., Hawes S.E., Wolner-Hanssen P.K., et al. Endometritis: the clinical-pathologic syndrome. Am J Obstet Gynecol 2002, 186(4):690-695.
50. Paavonen J., Kiviat N., Brunham R.C., et al. Prevalence and manifestations of endometritis among women with cervicitis. Am J Obstet Gynecol 1985, 152(3):280-286.
51. Kahn J.G., Walker C.K., Washington A.E., et al. Diagnosing pelvic inflammatory disease. A comprehensive analysis and considerations for developing a new model. JAMA 1991, 266(18):2594-2604.
52. Peipert J.F., Ness R.B., Blume J., et al. Clinical predictors of endometritis in women with symptoms and signs of pelvic inflammatory disease. Am J Obstet Gynecol 2001, 184(5):856-863. [discussion: 63-4].
53. Yudin M.H., Hillier S.L., Wiesenfeld H.C., et al. Vaginal polymorphonuclear leukocytes and bacterial vaginosis as markers for histologic endometritis among women without symptoms of pelvic inflammatory disease. Am J Obstet Gynecol 2003, 188(2):318-323.
54. Peipert J.F., Boardman L., Hogan J.W., et al. Laboratory evaluation of acute upper genital tract infection. Obstet Gynecol 1996, 87(5 Pt 1):730-736.
55. Cacciatore B., Leminen A., Ingman-Friberg S., et al. Transvaginal sonographic findings in ambulatory patients with suspected pelvic inflammatory disease. Obstet Gynecol 1992, 80(6):912-916.
56. Timor-Tritsch I.E., Lerner J.P., Monteagudo A., et al. Transvaginal sonographic markers of tubal inflammatory disease. Ultrasound Obstet Gynecol 1998, 12(1):56-66.
57. Molander P., Finne P., Sjoberg J., et al. Observer agreement with laparoscopic diagnosis of pelvic inflammatory disease using photographs. Obstet Gynecol 2003, 101(5 Pt 1):875-880.
58. Tukeva T.A., Aronen H.J., Karjalainen P.T., et al. MR imaging in pelvic inflammatory disease: comparison with laparoscopy and us. Radiology 1999, 210(1):209-216.
59. Wolner-Hanssen P., Paavonen J., Kiviat N., et al. Outpatient treatment of pelvic inflammatory disease with cefoxitin and doxycycline. Obstet Gynecol 1988, 71(4):595-600.
60. Arredondo J.L., Diaz V., Gaitan H., et al. Oral clindamycin and ciprofloxacin versus intramuscular ceftriaxone and oral doxycycline in the treatment of mild-to-moderate pelvic inflammatory disease in outpatients. Clin Infect Dis 1997, 24(2):170-178.
61. Ness R.B., Soper D.E., Holley R.L., et al. Effectiveness of inpatient and outpatient treatment strategies for women with pelvic inflammatory disease: results from the Pelvic Inflammatory Disease Evaluation and Clinical Health (PEACH) randomized trial. Am J Obstet Gynecol 2002, 186(5):929-937.
62. Ness R.B., Trautmann G., Richter H.E., et al. Effectiveness of treatment strategies of some women with pelvic inflammatory disease: a randomized trial. Obstet Gynecol 2005, 106(3):573-580.
63. Dunbar-Jacob J., Sereika S.M., Foley S.M., et al. Adherence to oral therapies in pelvic inflammatory disease. JWomens Health (Larchmt) 2004, 13(3):285-291.
64. Augenbraun M.H., McCormack W.H. Pelvic inflammatory disease: an ongoing epidemic. Hosp Pract (1995) 1995, 30(9):61-66.
65. Katz B.P., Zwickl B.W., Caine V.A., et al. Compliance with antibiotic therapy for Chlamydia trachomatis and Neisseria gonorrhoeae. Sex Transm Dis 1992, 19(6):351-354.
66. Hemsell D.L., Little B.B., Faro S., et al. Comparison of three regimens recommended by the centers for disease control and prevention for the treatment of women hospitalized with acute pelvic inflammatory disease. Clin Infect Dis 1994, 19(4):720-727.
67. Workowski K.A., Berman S. Sexually transmitted diseases treatment guidelines, 2010. MMWR Recomm Rep 2010, 59(RR-12):1-110.
68. Workowski K.A., Berman S.M. Sexually transmitted diseases treatment guidelines, 2006. MMWR Recomm Rep 2006, 55(RR-11):1-94.
69. Katz A.R., Lee M.V., Wasserman G.M. Sexually transmitted disease (STD) update: a review of the CDC 2010 STD treatment guidelines and epidemiologic trends of common STDs in Hawai'i. Hawaii J Med Public Health 2012, 71(3):68-73.
70. Bevan C.D., Ridgway G.L., Rothermel C.D. Efficacy and safety of azithromycin as monotherapy or combined with metronidazole compared with two standard multidrug regimens for the treatment of acute pelvic inflammatory disease. JInt Med Res 2003, 31(1):45-54.
71. Savaris R.F., Teixeira L.M., Torres T.G., et al. Comparing ceftriaxone plus azithromycin or doxycycline for pelvic inflammatory disease: a randomized controlled trial. Obstet Gynecol 2007, 110(1):53-60.
72. Haggerty C.L., Totten P.A., Astete S.G., et al. Failure of cefoxitin and doxycycline to eradicate endometrial Mycoplasma genitalium and the consequence for clinical cure of pelvic inflammatory disease. Sex Transm Infect 2008, 84(5):338-342.
73. Manhart L.E., Broad J.M., Golden M.R. Mycoplasma genitalium: should we treat and how?. Clin Infect Dis 2011, 53(Suppl 3):S129-S142.
74. Haggerty C.L., Hillier S.L., Bass D.C., et al. Bacterial vaginosis and anaerobic bacteria are associated with endometritis. Clin Infect Dis 2004, 39(7):990-995.
75. Swidsinski A., Verstraelen H., Loening-Baucke V., et al. Presence of a polymicrobial endometrial biofilm in patients with bacterial vaginosis. PLoS One 2013, 8(1):e53997.
76. Walker C.K., Workowski K.A., Washington A.E., et al. Anaerobes in pelvic inflammatory disease: implications for the centers for disease control and prevention's guidelines for treatment of sexually transmitted diseases. Clin Infect Dis 1999, 28(Suppl 1):S29-S36.
77. Landers D.V., Sweet R.L. Tubo-ovarian abscess: contemporary approach to management. Rev Infect Dis 1983, 5(5):876-884.
78. Reed S.D., Landers D.V., Sweet R.L. Antibiotic treatment of tuboovarian abscess: comparison of broad-spectrum beta-lactam agents versus clindamycin-containing regimens. Am J Obstet Gynecol 1991, 164(6 Pt 1):1556-1561. [discussion: 61-2].
79. Gjelland K., Ekerhovd E., Granberg S. Transvaginal ultrasound-guided aspiration for treatment of tubo-ovarian abscess: a study of 302 cases. Am J Obstet Gynecol 2005, 193(4):1323-1330.
80. Goharkhay N., Verma U., Maggiorotto F. Comparison of CT- or ultrasound-guided drainage with concomitant intravenous antibiotics vs. intravenous antibiotics alone in the management of tubo-ovarian abscesses. Ultrasound Obstet Gynecol 2007, 29(1):65-69.
81. Irwin K.L., Moorman A.C., O'Sullivan M.J., et al. Influence of human immunodeficiency virus infection on pelvic inflammatory disease. Obstet Gynecol 2000, 95(4):525-534.
82. Korn A.P., Landers D.V., Green J.R., et al. Pelvic inflammatory disease in human immunodeficiency virus-infected women. Obstet Gynecol 1993, 82(5):765-768.
83. Cohen C.R., Sinei S., Reilly M., et al. Effect of human immunodeficiency virus type 1 infection upon acute salpingitis: a laparoscopic study. JInfect Dis 1998, 178(5):1352-1358.
84. Kamenga M.C., De Cock K.M., St Louis M.E., et al. The impact of human immunodeficiency virus infection on pelvic inflammatory disease: a case-control study in Abidjan, Ivory Coast. Am J Obstet Gynecol 1995, 172(3):919-925.
85. Mugo N.R., Kiehlbauch J.A., Nguti R., et al. Effect of human immunodeficiency virus-1 infection on treatment outcome of acute salpingitis. Obstet Gynecol 2006, 107(4):807-812.
86. Bukusi E.A., Cohen C.R., Stevens C.E., et al. Effects of human immunodeficiency virus 1 infection on microbial origins of pelvic inflammatory disease and on efficacy of ambulatory oral therapy. Am J Obstet Gynecol 1999, 181(6):1374-1381.
87. Heaton F.C., Ledger W.J. Postmenopausal tuboovarian abscess. Obstet Gynecol 1976, 47(1):90-94.
88. Protopapas A.G., Diakomanolis E.S., Milingos S.D., et al. Tubo-ovarian abscesses in postmenopausal women: gynecological malignancy until proven otherwise?. Eur J Obstet Gynecol Reprod Biol 2004, 114(2):203-209.
89. Lipscomb G.H., Ling F.W. Tubo-ovarian abscess in postmenopausal patients. South Med J 1992, 85(7):696-699.
90. Hoffman M., Molpus K., Roberts W.S., et al. Tuboovarian abscess in postmenopausal women. JReprod Med 1990, 35(5):525-528.
91. Gareen I.F., Greenland S., Morgenstern H. Intrauterine devices and pelvic inflammatory disease: meta-analyses of published studies, 1974-1990. Epidemiology 2000, 11(5):589-597.
92. Feldblum P.J., Caraway J., Bahamondes L., et al. Randomized assignment to copper IUD or depot-medroxyprogesterone acetate: feasibility of enrollment, continuation and disease ascertainment. Contraception 2005, 72(3):187-191.
93. Farley T.M., Rosenberg M.J., Rowe P.J., et al. Intrauterine devices and pelvic inflammatory disease: an international perspective. Lancet 1992, 339(8796):785-788.
94. Mohllajee A.P., Curtis K.M., Peterson H.B. Does insertion and use of an intrauterine device increase the risk of pelvic inflammatory disease among women with sexually transmitted infection? A systematic review. Contraception 2006, 73(2):145-153.
95. Sufrin C.B., Postlethwaite D., Armstrong M.A., et al. Neisseria gonorrhoeae and Chlamydia trachomatis screening at intrauterine device insertion and pelvic inflammatory disease. Obstet Gynecol 2012, 120(6):1314-1321.
96. Sivin I., Stern J., Diaz J., et al. Two years of intrauterine contraception with levonorgestrel and with copper: a randomized comparison of the TCU 380ag and levonorgestrel 20 mcg/day devices. Contraception 1987, 35(3):245-255.
97. Soderberg G., Lindgren S. Influence of an intrauterine device on the course of an acute salpingitis. Contraception 1981, 24(2):137-143.
98. Haggerty C.L., Peipert J.F., Weitzen S., et al. Predictors of chronic pelvic pain in an urban population of women with symptoms and signs of pelvic inflammatory disease. Sex Transm Dis 2005, 32(5):293-299.
99. Scholes D., Stergachis A., Heidrich F.E., et al. Prevention of pelvic inflammatory disease by screening for cervical chlamydial infection. NEngl J Med 1996, 334(21):1362-1366.
100. Ostergaard L., Andersen B., Moller J.K., et al. Home sampling versus conventional swab sampling for screening of Chlamydia trachomatis in women: a cluster-randomized 1-year follow-up study. Clin Infect Dis 2000, 31(4):951-957.
101. Marrazzo J.M., Martin D.H. Management of women with cervicitis. Clin Infect Dis 2007, 44(Suppl 3):S102-S110.
102. Paavonen J., Aine R., Teisala K., et al. Comparison of endometrial biopsy and peritoneal fluid cytologic testing with laparoscopy in the diagnosis of acute pelvic inflammatory disease. Am J Obstet Gynecol 1985, 151(5):645-650.
103. Walker C.K., Landers D.V., Ohm-Smith M.J., et al. Comparison of cefotetan plus doxycycline with cefoxitin plus doxycycline in the inpatient treatment of acute salpingitis. Sex Transm Dis 1991, 18(2):119-123.
104. Comparative evaluation of clindamycin/gentamicin and cefoxitin/doxycycline for treatment of pelvic inflammatory disease: a multi-center trial. The European Study Group. Acta Obstet Gynecol Scand 1992, 71(2):129-134.
105. McGregor J.A., Crombleholme W.R., Newton E., et al. Randomized comparison of ampicillin-sulbactam to cefoxitin and doxycycline or clindamycin and gentamicin in the treatment of pelvic inflammatory disease or endometritis. Obstet Gynecol 1994, 83(6):998-1004.
106. Walters M.D., Gibbs R.S. Arandomized comparison of gentamicin-clindamycin and cefoxitin-doxycycline in the treatment of acute pelvic inflammatory disease. Obstet Gynecol 1990, 75(5):867-872.
107. Piyadigamage A., Wilson J. Improvement in the clinical cure rate of outpatient management of pelvic inflammatory disease following a change in therapy. Sex Transm Infect 2005, 81(3):233-235.