Treatment of hopitalized patients with acute pelvic inflammatory disease

Comparison of cefotetan plus doxycycline and cefoxitin plus doxycycline

Richard L Sweet, J. Schachter, D. V. Landers, M. Ohm-Smith, M. O. Robbie

Research output: Contribution to journalArticle

48 Citations (Scopus)

Abstract

Acute pelvic inflammatory disease remains the major medical and economic consequence of sexuality transmitted diseases among young women. The polymicrobial origins of pelvic inflammatory disease have been well documented and the major organisms recovered from the upper genital tract in patients with pelvic inflammatory disease include Chlamydia trachomatis, Neisseria gonorrhoeae, and mixed anaerobic and aerobic bacteria. This study was undertaken to compare the efficacy and safety of cefotetan plus doxycycline with that of cefoxitin plus doxycycline in the treatment of hospitalized patients with acute pelvic inflammatory disease. A total of 68 hospitalized patients with acute pelvic inflammatory disease were entered and randomized into two treatment groups: cefotetan (n = 32) and cefoxitin (n = 36). There were six tuboovarian abscesses in each group. C. trachomatis was recovered from 7 (10%) and N. gonorrhoeae from 48 (71%) of the patients. Anaerobic an aerobic bacteria were recovered from the upper genital tract in 53 (78%) of the patients. Cefotetan plus doxycycline and cefoxitin plus doxycycline demonstrated high rates of initial clinical response in the treatment of acute pelvic inflammatory disease. Clinical cure was noted in 30 (94%) of the cefotetan plus doxycycline group and 33 (92%) of the cefoxitin plus doxycycline group. Four failures were sonographically diagnosed tuboovarian abscesses that responded to clindamycin plus gentamicin therapy. The fifth failure was an uncomplicated case that did not respond to cefoxitin and doxycycline and required additional therapy. At 1 week and 3 weeks, respectively, the posttreatment cultures demonstrated eradication, in all instances, of N. gonorrhoeae and C. trachomatis. These regimens also were very effective in eradicating anaerobic and aerobic pathogens from the endometrial cavity. Both regimens were well tolerated by the patients, and few adverse drug affects were noted.

Original languageEnglish (US)
Pages (from-to)736-743
Number of pages8
JournalAmerican Journal of Obstetrics and Gynecology
Volume158
Issue number3 II SUPPL.
StatePublished - 1988

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Cefotetan
Cefoxitin
Pelvic Inflammatory Disease
Doxycycline
Neisseria gonorrhoeae
Chlamydia trachomatis
Aerobic Bacteria
Anaerobic Bacteria
Abscess
Therapeutics
Medical Economics
Clindamycin
Sexuality
Gentamicins
Safety

ASJC Scopus subject areas

  • Medicine(all)
  • Obstetrics and Gynecology

Cite this

Treatment of hopitalized patients with acute pelvic inflammatory disease : Comparison of cefotetan plus doxycycline and cefoxitin plus doxycycline. / Sweet, Richard L; Schachter, J.; Landers, D. V.; Ohm-Smith, M.; Robbie, M. O.

In: American Journal of Obstetrics and Gynecology, Vol. 158, No. 3 II SUPPL., 1988, p. 736-743.

Research output: Contribution to journalArticle

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abstract = "Acute pelvic inflammatory disease remains the major medical and economic consequence of sexuality transmitted diseases among young women. The polymicrobial origins of pelvic inflammatory disease have been well documented and the major organisms recovered from the upper genital tract in patients with pelvic inflammatory disease include Chlamydia trachomatis, Neisseria gonorrhoeae, and mixed anaerobic and aerobic bacteria. This study was undertaken to compare the efficacy and safety of cefotetan plus doxycycline with that of cefoxitin plus doxycycline in the treatment of hospitalized patients with acute pelvic inflammatory disease. A total of 68 hospitalized patients with acute pelvic inflammatory disease were entered and randomized into two treatment groups: cefotetan (n = 32) and cefoxitin (n = 36). There were six tuboovarian abscesses in each group. C. trachomatis was recovered from 7 (10{\%}) and N. gonorrhoeae from 48 (71{\%}) of the patients. Anaerobic an aerobic bacteria were recovered from the upper genital tract in 53 (78{\%}) of the patients. Cefotetan plus doxycycline and cefoxitin plus doxycycline demonstrated high rates of initial clinical response in the treatment of acute pelvic inflammatory disease. Clinical cure was noted in 30 (94{\%}) of the cefotetan plus doxycycline group and 33 (92{\%}) of the cefoxitin plus doxycycline group. Four failures were sonographically diagnosed tuboovarian abscesses that responded to clindamycin plus gentamicin therapy. The fifth failure was an uncomplicated case that did not respond to cefoxitin and doxycycline and required additional therapy. At 1 week and 3 weeks, respectively, the posttreatment cultures demonstrated eradication, in all instances, of N. gonorrhoeae and C. trachomatis. These regimens also were very effective in eradicating anaerobic and aerobic pathogens from the endometrial cavity. Both regimens were well tolerated by the patients, and few adverse drug affects were noted.",
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