Heinonen P K, Teisala K, Miettinen A, Aine R, Punnonen R, Grönroos P
Department of Obstetrics and Gynecology, Tampere University Central Hospital, Finland.
Scand J Infect Dis Suppl. 1989;60:66-73.
We studied the clinical and microbiological response to two treatment regimens in 36 patients with acute pelvic inflammatory disease (PID). All patients were hospitalized and underwent laparoscopy and endometrial biopsy. Cervical, endometrial, tubal and peritoneal cultures for Chlamydia trachomatis, Neisseria gonorrhoeae, genital mycoplasmas, facultative and anaerobic bacteria and Herpes simplex virus were obtained. The patients were randomly assigned to two treatment groups: 16 women received ciprofloxacin 200 mg b.i.d. iv. for two days, followed by oral administration with 750 mg b.i.d. to complete a 14-day course of treatment. Twenty women received the combination of doxycycline and metronidazole according to a similar scheme of administration. The response was evaluated with repeated clinical examinations, monitoring of the erythrocyte sedimentation rate and serum C-reactive protein concentration, and repeated microbial culture from the cervix. Ciprofloxacin treatment was successful in all nine patients with chlamydial or gonococcal PID and in six of seven with nonchlamydial nongonococcal PID. Doxycycline plus metronidazole regimen was successful in five of seven patients with chlamydial or gonococcal PID and in nine of 13 patients with nonchlamydial nongonococcal PID. Thus, the overall success rate was 94% (15 of 16) with ciprofloxacin and 70% (14 of 20) with doxycycline plus metronidazole. Our study suggests that ciprofloxacin is a promising new alternative for the treatment of acute PID.
我们研究了36例急性盆腔炎（PID）患者对两种治疗方案的临床和微生物学反应。所有患者均住院并接受腹腔镜检查和子宫内膜活检。获取了宫颈、子宫内膜、输卵管和腹膜的沙眼衣原体、淋病奈瑟菌、生殖支原体、兼性和厌氧菌以及单纯疱疹病毒培养物。患者被随机分为两个治疗组：16名女性静脉注射环丙沙星200mg，每日两次，共两天，随后口服750mg，每日两次，完成14天的治疗疗程。20名女性按照类似的给药方案接受多西环素和甲硝唑联合治疗。通过重复临床检查、监测红细胞沉降率和血清C反应蛋白浓度以及重复进行宫颈微生物培养来评估反应。环丙沙星治疗对所有9例衣原体或淋菌性PID患者以及7例非衣原体非淋菌性PID患者中的6例均成功。多西环素加甲硝唑方案对7例衣原体或淋菌性PID患者中的5例以及13例非衣原体非淋菌性PID患者中的9例成功。因此，环丙沙星的总体成功率为94%（16例中的15例），多西环素加甲硝唑为70%（20例中的14例）。我们的研究表明，环丙沙星是治疗急性PID的一种有前景的新选择。
