PELVIC INFLAMMATORY DISEASE – MANAGEMENT
Hospitalisation will be necessary if the patient is severely ill or if an
abdominal emergency such as acute appendicitis or ectopic pregnancy has not been excluded. Other indications for hospital treatment include pregnancy, inability to tolerate oral medication, expected poor compliance with oral therapy, failed outpatient management or suspected pelvic abscess. Patients who are prepubertal or adolescent are at risk of severe complications and should be admitted.
Various antibiotic regimens are used depending on the clinical situation.
Therapy should be commenced as soon as possible and not delayed until investigations are complete. Treatment should be selected according to the most probable infecting organism and the severity of symptoms. Hospitalised patients may require intravenous chemotherapy which can be replaced by oral treatment following clinical improvement. Antimicrobial therapy should be continued for at least ten days. Bed rest and sexual abstinence are of benefit during therapy. If an IUCD is present it should be removed following commencement of antibiotics.
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