Fischbach F, Deckardt R, Graeff H
Frauenklinik, Technischen Universität München, Klinikum rechts der Isar.
Geburtshilfe Frauenheilkd. 1994 Jun;54(6):337-40. doi: 10.1055/s-2007-1022851.
The efficacy and safety of two antibiotic regimens for the treatment of acute pelvic inflammatory disease (PID) was compared in a prospective and randomised study. 57 patients received either 0.2 gms ciprofloxacin intravenously b.i.d. in combination with 0.5 g metronidazole intravenously t.i.d. (n = 26), or alternatively 2 g cefoxitin intravenously t.i.d. in combination with doxycycline 0.1 g b.i.d. (n = 31). After commencing therapy intravenously, medication with ciprofloxacin, metronidazole and doxycycline was continued orally after two or three days. In the ciprofloxacin/metronidazole group, PID was found to be severe in 7, moderate in 12 and mild in 7 patients. The numbers in the cefoxitin/doxycycline group were 8, 20 and 3 respectively. The clinical result after treatment with ciprofloxacin/metronidazole was resolution of all symptoms in 24 patients and improvement in 2 others. In the cefoxitin/doxycycline treated group, resolution was found in 27 patients, improvement in 2 others. Failure occurred in 2 patients. 53 different microorganisms as the suspected cause of PID were isolated in the ciprofloxacin/metronidazole group and 56 in the cefoxitin/doxycycline group. According to our clinical and bacteriological criteria, treatment for PID was successful in 97% of the ciprofloxacin/metronidazole group and in 87% of the cefoxitin/doxycycline group. Adverse reactions were found in 4 patients in the ciprofloxacin/metronidazole treated group. Therapy had to be terminated in 3 of these patients. In the cefoxitin/doxycycline group 2 patients had adverse reactions, and therapy had to be terminated in one of these patients. According to our results, both antibiotic regimens can be recommended for the treatment of PID.
在一项前瞻性随机研究中，比较了两种抗生素治疗方案对急性盆腔炎（PID）的疗效和安全性。57例患者分别接受以下治疗：静脉注射0.2克环丙沙星，每日两次，联合静脉注射0.5克甲硝唑，每日三次（n = 26）；或者静脉注射2克头孢西丁，每日三次，联合口服0.1克多西环素，每日两次（n = 31）。静脉治疗开始后，两到三天后环丙沙星、甲硝唑和多西环素改为口服给药。在环丙沙星/甲硝唑组中，7例患者的PID为重度，12例为中度，7例为轻度。头孢西丁/多西环素组的相应数字分别为8例、20例和3例。环丙沙星/甲硝唑治疗后，24例患者所有症状消失，2例有所改善。在头孢西丁/多西环素治疗组中，27例患者症状消失，2例有所改善。2例治疗失败。环丙沙星/甲硝唑组分离出53种不同微生物，疑似为PID的病因，头孢西丁/多西环素组为56种。根据我们的临床和细菌学标准，环丙沙星/甲硝唑组97%的PID治疗成功，头孢西丁/多西环素组为87%。环丙沙星/甲硝唑治疗组有4例患者出现不良反应，其中3例治疗不得不终止。头孢西丁/多西环素组有2例患者出现不良反应，其中1例治疗不得不终止。根据我们的结果，两种抗生素治疗方案均可推荐用于PID的治疗。
