Oral Clindamycin And Ciprofloxacin Versus Intramuscular Ceftriaxone ...

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Abstract

This multicenter, prospective, double-blind study compared the safety and efficacy of clindamycin and ciprofloxacin versus ceftriaxone and doxycycline in the treatment of outpatients with mild to moderate pelvic inflammatory disease (PID) diagnosed by laparoscopy. Samples taken from the endocervix, endometrium, and abdominal cavity before treatment and from the endocervix after treatment were cultured for aerobes, anaerobes, Neisseria gonorrhoeae, and Chlamydia trachomatis. Of the 138 patients enrolled, 131 were evaluable for efficacy. The most prevalent bacteria were streptococci, staphylococci, and Escherichia coli (among aerobes) and Bacteroides species and peptostreptococci (among anaerobes). N. gonorrhoeae was present in 2% (3) of the 131 evaluable patients, and C. trachomatis was in 11% (15). The clinical cure rate was 97% (65 of 67) in the clindamycin and ciprofloxacin group and 95% (61 of 64) in the ceftriaxone and doxycycline group. Side effects were similar in both groups. In conclusion, the two regimens for the outpatient treatment of mild to moderate PID were similarly effective and safe.

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• A randomized comparison of gentamicin-clindamycin and cefoxitin-doxycycline in the treatment of acute pelvic inflammatory disease. Walters MD, Gibbs RS. Walters MD, et al. Obstet Gynecol. 1990 May;75(5):867-72. Obstet Gynecol. 1990. PMID: 2183112 Clinical Trial.
• A comparison of ciprofloxacin with doxycycline plus metronidazole in the treatment of acute pelvic inflammatory disease. Heinonen PK, Teisala K, Miettinen A, Aine R, Punnonen R, Grönroos P. Heinonen PK, et al. Scand J Infect Dis Suppl. 1989;60:66-73. Scand J Infect Dis Suppl. 1989. PMID: 2756353 Clinical Trial.
• [Ciprofloxacin/metronidazole vs. cefoxitin/doxycycline: comparison of two therapy schedules for treatment of acute pelvic infection]. Fischbach F, Deckardt R, Graeff H. Fischbach F, et al. Geburtshilfe Frauenheilkd. 1994 Jun;54(6):337-40. doi: 10.1055/s-2007-1022851. Geburtshilfe Frauenheilkd. 1994. PMID: 8088489 Clinical Trial. German.
• Newest approaches to treatment of pelvic inflammatory disease: a review of recent randomized clinical trials. Haggerty CL, Ness RB. Haggerty CL, et al. Clin Infect Dis. 2007 Apr 1;44(7):953-60. doi: 10.1086/512191. Epub 2007 Feb 15. Clin Infect Dis. 2007. PMID: 17342647 Review.
• Optimum therapy for acute pelvic inflammatory disease. Dodson MG. Dodson MG. Drugs. 1990 Apr;39(4):511-22. doi: 10.2165/00003495-199039040-00004. Drugs. 1990. PMID: 2190794 Review.

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Cited by

• Antibiotic therapy for pelvic inflammatory disease. Savaris RF, Fuhrich DG, Maissiat J, Duarte RV, Ross J. Savaris RF, et al. Cochrane Database Syst Rev. 2020 Aug 20;8(8):CD010285. doi: 10.1002/14651858.CD010285.pub3. Cochrane Database Syst Rev. 2020. PMID: 32820536 Free PMC article.
• The Anti-Inflammatory Effect of Feiyangchangweiyan Capsule and Its Main Components on Pelvic Inflammatory Disease in Rats via the Regulation of the NF-κB and BAX/BCL-2 Pathway. Li Y, Yang Q, Shi ZH, Zhou M, Yan L, Li H, Xie YH, Wang SW. Li Y, et al. Evid Based Complement Alternat Med. 2019 Jun 13;2019:9585727. doi: 10.1155/2019/9585727. eCollection 2019. Evid Based Complement Alternat Med. 2019. PMID: 31312226 Free PMC article.
• Antibiotic therapy for pelvic inflammatory disease: an abridged version of a Cochrane systematic review and meta-analysis of randomised controlled trials. Savaris RF, Fuhrich DG, Duarte RV, Franik S, Ross JDC. Savaris RF, et al. Sex Transm Infect. 2019 Feb;95(1):21-27. doi: 10.1136/sextrans-2018-053693. Epub 2018 Oct 19. Sex Transm Infect. 2019. PMID: 30341232 Free PMC article.
• Antibiotic therapy for pelvic inflammatory disease. Savaris RF, Fuhrich DG, Duarte RV, Franik S, Ross J. Savaris RF, et al. Cochrane Database Syst Rev. 2017 Apr 24;4(4):CD010285. doi: 10.1002/14651858.CD010285.pub2. Cochrane Database Syst Rev. 2017. Update in: Cochrane Database Syst Rev. 2020 Aug 20;8:CD010285. doi: 10.1002/14651858.CD010285.pub3. PMID: 28436019 Free PMC article. Updated. Review.
• Pelvic inflammatory disease. Ross JD. Ross JD. BMJ Clin Evid. 2013 Dec 11;2013:1606. BMJ Clin Evid. 2013. PMID: 24330771 Free PMC article. Review.

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