Pharmacologic Treatment

© Resolution of infection (i.e., N. gonorrhoeae, C. trachomatis, Streptococcus spp., and gram-negative facultative bacteria) and mitigation of sequelae should be the main goal of pharmacologic therapy. CDC-approved treatment regimens are shown in Table 80-4.4,38,43 Optimal management of PID should be individualized based on clinical setting and patient characteristics. For some patients, hospitalizations, IV antibiotics, and surgical treatment of complications may be needed. Though outpatient management remains contentious, many feel that outpatient management should be limited to individuals who: remain afebrile, have a WBC counts less than 11

x 10 /mm (11 x 10 L), have minimal evidence of peritonitis, have active bowel sounds, and can tolerate oral nourishment. Nonetheless, outpatient therapy with a parenteral cephalosporin or levofloxacin followed by doxycycline and metronidazole is recommended.

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