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Women with mild-to-moderate pelvic inflammatory disease have similar reproductive outcomes from inpatient and outpatient care
Pelvic inflammatory disease (PID) affects about 8 percent of all women of reproductive age in the United States. PID can lead to infertility, tubal pregnancy, and chronic pelvic pain. Over three-fourths of women treated for PID are managed as outpatients, a move away from hospital-based management that has accelerated over the past two decades. A new Pelvic Inflammatory Disease Evaluation and Clinical Health (PEACH) study, supported in part by the Agency for Healthcare Research and Quality (HS08358), found no differences in reproductive outcomes among women with mild-to-moderate PID regardless of whether they were treated as inpatients or outpatients.
Roberta B. Ness, M.D., M.P.H., of the University of Pittsburgh, and colleagues randomized 831 women with clinical signs and symptoms of mild-to-moderate PID into a multicenter trial. Inpatient treatment included intravenous cefoxitin and doxycycline, while outpatient treatment consisted of a single intramuscular injection of cefoxitin and oral doxycyline. They followed the treatment groups for an average of 84 months. When compared with inpatient treatment, outpatient treatment did not adversely affect pregnancy frequency, live births, tubal pregnancies, time to pregnancy, infertility, PID recurrence, or chronic pelvic pain, regardless of factors such as race, previous PID, the presence of Neisseria gonorrhoeae and/or Chlamydia trachomatis infection, or a high temperature, high white blood cell count, and pelvic tenderness.
More details are in "Effectiveness of treatment strategies of some women with pelvic inflammatory disease," by Dr. Ness, Gail Trautmann, M.A., Holly E. Richter, Ph.D., M.D. and others, in the September 2005 Obstetrics & Gynecology 106(3), pp. 573-580.
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