Pelvic Inflammatory Disease

Micro-organism

Chlamydia trachomatis, Neisseria gonorrhoeae, intestinal aerobes and anaerobes

Duration

14 days

Notes
  • For full guidelines see British Association of Sexual Health and HIV  
  • Send blood for culture if pyrexial.
  • If STD is suspected patients should be referred to Sexual Health Service (0345 337 9900) for partner notification and advice if required.

Samples: self obtained low vaginal swab or endocervical swab.

Consider immune deficiency and testing for HIV.

Refer to obstetrics guideline for pregnancy/breastfeeding options.

Inpatient regimen

IV Ceftriaxone 2g once only

Then

Oral Doxycycline 100mg 12 hourly

+ Oral Metronidazole 400mg 12 hourly

If IV therapy is required, seek specialist advice.

Metronidazole has been added to cover anaerobes, which have a greater importance in severe PID.  Metronidazole can be omitted in mild to moderate PID or if not tolerated.

Inpatient regimen - penicillin allergy

Refer to BASHH 2018 guideline

Outpatient regimen

IM Ceftriaxone 500mg once only

Then

Oral Doxycycline 100mg 12 hourly

+ Oral Metronidazole 400mg 12 hourly

Metronidazole has been added to cover anaerobes, which have a greater importance in severe PID. Metronidazole can be omitted in mild to moderate PID or if not tolerated.

Outpatient regimen - penicillin allergy

Refer to BASHH 2018 guideline