Antibiotic regimens for treating acute pelvic inflammatory disease. An evaluation.

A statistical analysis of 58 reports involving 101 clinical trials and over 4,000 patients revealed that there was no statistically significant difference in the cure rates between single-agent and combination therapy. Also, there was no difference in the cure rates between antibiotic regimens that cover Chlamydia trachomatis and those that do not. However, there was a difference in cure rates when regimens with good antianaerobe activity were compared to those with poor coverage of anaerobes. There was a statistically significantly higher cure rate when "newer" regimens (mainly the second and third generations of cephalosporins and newer penicillins) were compared to "older" regimens (mainly penicillin and tetracycline). In 91 comparisons there were no statistically significant differences between regimens with a > 90% cure rate. Optimum therapy is discussed in terms of the cure rate, coverage of known pathogens and antibiotic toxicity. The original and revised recommendations of the Centers for Disease Control for the treatment of acute pelvic inflammatory disease are also reviewed.