Pelvic Inflammatory Disease

Important: Therapy

• For full guidelines see British Association of Sexual Health and HIV.  Please note that IV Doxycycline is not routinely available in the UK; oral doxycycline is highly bioavailable.  
• Send blood for culture if pyrexial.
• If STI 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.
• Check microbiology results and amend antibiotic regime once pathogens known.

Consider immune deficiency and testing for HIV.

Notes:

Important: Therapy

The following therapy is recommended in more severe clinical disease eg pyrexia >38⁰C, signs of tubo-ovarian abscess or pelvic peritonitis. Seek specialist advice.  Continue IV ceftriaxone until 24 hours after clinical improvement then switch to oral.

IV Ceftriaxone 2g once daily

+

Oral Doxycycline 100mg 12 hourly

+
Oral Metronidazole 400mg 12 hourly

Switch to

Oral Doxycycline 100mg 12 hourly

+

Oral Metronidazole 400mg 12 hourly

Notes:

Important: Therapy

Assess penicillin allergy – refer to Penicillin Allergy poster 

If a penicillin allergy regimen is required, refer to BASHH guideline 

Notes:

Important: Therapy

IM Ceftriaxone 1g single dose

+

Oral Doxycycline 100mg twice daily

+

Oral Metronidazole 400mg twice daily

Notes:

Important: Therapy

Assess penicillin allergy – refer to Penicillin Allergy poster

If a penicillin allergy regimen is required, refer to BASHH guideline

Notes: