Acta Medica Medianae
Institut za farmakologiju sa toksikologijom Medicinskog fakulteta
Dr Zorana Đinđića 81, 18000 Niš, Srbija
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Copyright 2008 by Faculty of Medicine, University of Nis
Antimicrobial Treatment of Obstetric and Gynecologic Infections
Srdjan Pesic, Leposava Grbovic and Valentina Nikolic
Treatment regimens for pelvic inflammatory diseases (PID), as a common cause of morbidity in women under the age of 45, should provide broad-spectrum coverage of likely etiologic pathogens and take into account the polymicrobial nature of PID. Antibiotic regimens that do provide coverage of these pathogens showed unacceptably high failure rates. The most recent edition of the Center for Disease Control and Prevention of Sexually Transmitted Disease Treatment guidelines provides an evidence-based and reliable set of recommendations for treating patients with PID and other sexually transmitted diseases.
Outpatient regimens for the treatment of mildly and moderately severe acute PID include ofloxacin or levofloxacin with or without metronidazole for anaerobic coverage for 14 days. Alternatively, a single dose ceftriaxone or cefoxitin plus probenecid, followed by doxycycline with or with metronidazole for 14 days. In more severe cases, inpatient antibiotic treatment should be based on intravenous therapy with cefotetan or cefoxitin plus doxycycline which should be continued until 24 hours after clinical improvement and followed by oral therapy with doxycycline and metronidazole. Clindamycin plus gentamicin can be used alternatively in penicillin-allergic and pregnant women.
Many antimicrobial regimens effectively treat uncomplicated gonorrhea, like single-dose ceftriaxone or cefoxitin or other pareneral third-generation cephalosporin. Treatment options for uncomplicated genitourinary chlamydial infection include a single dose azithromycin orally or doxycycline for seven days. A first-line drug for chlamydial infection in pregnant women is erythromycin base or amoxicillin. Acta Medica Medianae 2008;47(3): 56-64.
Key words: infections, obstetric, gynecologic, antibiotics