Chen Li-Yeh, Harnod Tomor, Chang Yu-Hsun, Chen Hsuan, Ding Dah-Ching
Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Foundation, Tzu Chi University, Hualien 970, Taiwan.
Department of Neurosurgery, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Foundation, Tzu Chi University, Hualien 970, Taiwan.
J Clin Med. 2021 Sep 14;10(18):4145. doi: 10.3390/jcm10184145.
Pelvic inflammatory disease (PID) affects 4.4% of women aged 18-44 in the United States, and may cause infertility if it is ineffectively treated. A combination of clindamycin and gentamicin is generally used for the treatment of PID. The benefit of adding metronidazole into the treatment combination still remains unclear, and this study was designed to evaluate its effectiveness. We retrospectively included 107 women who were diagnosed with PID from May 2013 to September 2020 in a single hospital. Based on their used antibiotic regimens, the patients were divided into three groups-those who were treated with clindamycin + gentamicin (group 1, = 46), those who took regular antibiotics plus metronidazole (group 2, = 27), and others (group 3, = 34). Primary outcomes included the rates of taking surgery after failed antibiotics, occurrence/rupture of tubo-ovarian abscesses, and readmission within the following 6 months of first treatment. Secondary outcomes to assess were the length of stay (LOS) and expenditure for PID. There were no significant differences in the surgical rates, readmission rates, LOS and expenditure noted between the three groups. Subgroup analysis showed that visual analogue pain scores being 5 or more would increase the LOS by 3.83 days ( < 0.001), and body temperature > 38.3 °C or more would increase the treatment total expenditure ( < 0.001). Our study results suggest that the combination of clindamycin + gentamicin is a convincible treatment protocol for PID.
盆腔炎（PID）影响着美国18至44岁女性中的4.4%，若治疗不当可能导致不孕。克林霉素和庆大霉素联合用药通常用于治疗PID。在治疗方案中加入甲硝唑的益处仍不明确，本研究旨在评估其有效性。我们回顾性纳入了2013年5月至2020年9月在一家医院被诊断为PID的107名女性。根据她们使用的抗生素治疗方案，将患者分为三组：接受克林霉素+庆大霉素治疗的患者（第1组，n = 46）、接受常规抗生素加甲硝唑治疗的患者（第2组，n = 27）以及其他患者（第3组，n = 34）。主要结局包括抗生素治疗失败后接受手术的比例、输卵管卵巢脓肿的发生/破裂情况以及首次治疗后接下来6个月内的再次入院情况。评估的次要结局为PID的住院时长（LOS）和费用。三组之间在手术率、再次入院率、LOS和费用方面均无显著差异。亚组分析显示，视觉模拟疼痛评分≥5分会使LOS增加3.83天（P < 0.001）；体温>38.3℃会增加治疗总费用（P < 0.001）。我们的研究结果表明，克林霉素+庆大霉素联合用药是治疗PID的一种可信治疗方案。
