Pelvic Inflammatory Disease
NHSL Antimicrobial Guidelines
If proven or high risk of STI, refer to GUM for treatment and partner notification.
Exclude pregnancy in women with pelvic pain.
Intravenous antibiotic therapy is recommended in more severe clinical disease: pyrexia >38◦C, tubo-ovarian abscess or pelvic peritonitis. Refer by phone to gynaecology.
Drug details
Drug
Mild to moderate:
ORAL Metronidazole
Dosage
400mg
Duration
twice daily 14 days
Drug
PLUS
ORAL Doxycycline
Dosage
100mg
Duration
twice daily 14 days
Drug
Second line:
ORAL Metronidazole
Dosage
400mg
Duration
twice daily 14 days
Drug
PLUS
ORAL Ofloxacin*
Dosage
400mg
Duration
twice daily 14 days
Drug
First line for M. genitalium associated PID (refer to GUM):
ORAL Moxifloxacin*
Dosage
400mg
Duration
once daily 14 days
Drug
If gonorrhoea suspected:
Refer to GUM for IM Ceftriaxone
Dosage
1g
Duration
single dose
Drug
PLUS
oral Metronidazole
Dosage
400mg
Duration
twice daily 14 days
Drug
PLUS
oral Doxycycline
Dosage
100mg
Duration
twice daily 14 days
*Consider safety issues with quinolones