Pelvic Inflammatory Disease- Antibiotic Management in Pregnancy

Inform Registrar who will review the patient after admission (preferably before initiating treatment).

Both locally and nationally, resistance in Gonococcal isolates has meant that both the penicillin and quinolone antibiotics can no longer be relied upon for empirical treatment of Gonococcal disease. Intramuscular ceftriaxone is now the standard treatment for infections where sensitivity results are unknown.

Ceftriaxone 250mg IM stat (for Gonococcal cover)

plus Erythromycin 500mg qds PO for 14 days and Metronidazole 400 mg bd PO for 5 days

Adjust antibiotics according to culture and sensitivity results only if no improvement, and after discussion with microbiology (in view of rising resistance in gonococcal isolates). 

The Full Guideline "Antibiotic Guideline for Acute Pelvic Inflammatory Disease" is available here.

Caution; the antibiotic doses recommended on this website are intended for adult patients with normal renal and liver function unless otherwise stated. Dosing advice for patients with renal impairment is available here.

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