Antibiotics for Pelvic Inflammatory Disease

Reference Pelvic inflammatory disease (PID) Opens New Window is often caused by a combination of different types of bacteria, so a combination (regimen) of medicines is used to treat the infection. Treatment changes as new medicines are developed or as the bacteria that cause the infection become Reference resistant Opens New Window to old medicines. Treatment guidelines from the U.S. Centers for Disease Control and Prevention recommend one of the following regimens:^{Reference 1}

Outpatient treatment options

Ceftriaxone plus doxycycline with or without metronidazole

Ceftriaxone is given one time as an injection in a muscle. Doxycycline is taken as pills twice a day usually for 14 days. Doxycycline is not used if you are pregnant. Avoid prolonged sun exposure while taking doxycycline. Metronidazole is taken as pills twice a day usually for 14 days. Do not drink alcohol when taking metronidazole. The number of days you continue to take antibiotics depends on your illness and the type of antibiotic medicine.

Cefoxitin with probenecid plus doxycycline with or without metronidazole

Cefoxitin is given one time as an injection in a muscle. Probenecid is taken as a pill in a single dose at the time of the shot. Doxycycline is taken as pills twice a day usually for 14 days. Doxycycline is not used if you are pregnant. Avoid prolonged sun exposure while taking doxycycline. Metronidazole is taken as pills twice a day usually for 14 days. Do not drink alcohol when taking metronidazole. The number of days you continue to take antibiotics depends on your illness and the type of antibiotic medicine.

Other antibiotic medicines are sometimes used for treating PID.

Inpatient treatment options

Some women need to be hospitalized for pelvic inflammatory disease treatment. In the hospital, antibiotics are first given through a vein (Reference intravenous, or IV Opens New Window) for at least 24 hours, followed by antibiotics by mouth, which are continued at home after discharge from the hospital. Total treatment with medicine usually lasts for 14 days.^{Reference 2}

· Inpatient intravenous, regimen A

Cefotetan

Cefotetan is given intravenously every 12 hours.

OR:

Cefoxitin plus doxycycline

Cefoxitin is given intravenously every 6 hours. Doxycycline is given intravenously or in pill form every 12 hours.

After at least 24 hours of intravenous antibiotics, oral antibiotics (doxycycline or clindamycin) are given.

· Inpatient intravenous, regimen B

Clindamycin is given intravenously every 8 hours. Gentamicin is given intravenously or by injection every 8 hours or once a day.

After at least 24 hours of intravenous antibiotics, oral antibiotics (doxycycline and/or clindamycin) are given.

· Alternative intravenous regimen

Ampicillin/sulbactam plus doxycycline

Ampicillin/sulbactam is given intravenously every 6 hours. Doxycycline is given intravenously or in pill form every 12 hours.

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