Pelvic Inflammatory Disease- Antibiotic Management, NBM/vomiting

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. Ceftriaxone is now the standard treatment for infections where sensitivity results are unknown.

Parenteral therapy:

Ceftriaxone 250mg stat IM

Plus Metronidazole 500mg tds IV and Clarithromycin 500mg bd IV

Change to oral Doxycycline 100mg bd PO plus Metronidazole 400mg tds PO to complete 14 days treatment as soon as patient is able to swallow.

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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