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* MHTEXT3 DB3 PLUS REVISION 06/02/86
*
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TREATMENT OF SALPINGITIS
Microbiologic data suggest that instead of the traditional view of
the gonococcus paving the way for secondary invaders, a mixed bacterial
infection with many different organisms, including Neisseria gonorrhea,
anaerobes and Chlamydia, is present from the outset. This observation
should influence antibiotic strategies.
In recent years there has been increasing awareness that Chlamydia is
important in infections of the female pelvis. The significance of Chlamydia
for the clinician is that it does not seem to cause the systemic symptoms
that we associate with acute pelvic infection. These patients can have an
infection that causes cumulative damage, altering the lining of the tubes
and causing tubal blockage, or it can cause extensive adhesion formation.
This progression occurs without the clinical symptoms of fever or lower
abdominal pain severe enough to cause patients to contact their physicians.
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CENTERS FOR DISEASE CONTROL
RECOMMENDED TREATMENT FOR ACUTE PID, 1982
Outpatients
Cefoxitin, 2 gm IV, or
Aqueous procaine penicillin-G, 4.8 million units IM, or
Ampicillin, 3.5 gm followed by
Tetracycline, 0.5 gm orally q.i.d. for 10 days, or
Doxycycline, 100 mg orally b.i.d. for 10 days of total therapy
Inpatients
1. Cefoxitin, 2 gm IV q6h, plus
Doxycycline, 100 mg IV b.i.d.
Parenteral treatment for minimum of 4 days with 48 hours afebrile,
followed by doxycycline, 100 mg b.i.d. for 10-14 days of total therapy
2. Clindamycin, 600 mg IV q6h, plus
Tobramycin/gentamicin, 1.5 mg/kg followed by 1 mg/kg q8h IV b.i.d.
Clindamycin 450 mg orally q.i.d. for 10-14 days of total therapy
3. Metronidazole, 500 mg IV b.i.d. plus
Doxycycline, 100 mg IV b.i.d.
Parenteral treatment for minimum of 4 days with 48 hours afebrile,
followed by same dosages orally b.i.d. for 10-14 days of total therapy
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REFERENCES
Ledger, M.D., William
"Diagnosis and Treatment of Salpingitis," Journal of Reproductive
Medicine, Vol. 28, No. 10 (Supplement), October, 1983.
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