Clinical Manual for Management of the HIV-Infected ... - myCME.com

Table 1. Treatment Regimens for Pelvic Inflammatory Disease
Section 6—Disease-Specific Treatment | 6–87
Antibiotic Regimens
Oral / Outpatient Treatment (see CDC STD Treatment Guidelines, referenced below)
Regimen 1 •
or
Ofloxacin* 400 mg orally twice daily for 14 days
• Levofloxacin* 500 mg orally once daily for 14 days
with or without
• Metronidazole 500 mg orally twice daily for 14 days (provides activity against anaerobes)
Regimen 2 •
or
Ceftriaxone 250 mg intramuscular (IM) injection in a single dose
•
or
Cefoxitin 2 g IM injection in a single dose, administered concurrently with probenecid 1 g orally in a single dose
• Other parenteral third generation cephalosporin (eg, ceftizoxime or cefotaxime)
plus
• Doxycycline 100 mg orally twice daily for 14 days
with or without
• Metronidazole 500 mg orally twice daily for 14 days
Parenteral / Inpatient Treatment
Regimen 1 •
or
Cefotetan 2 g intravenously (IV) every 12 hours
• Cefoxitin 2 g IV every 6 hours
plus
• Doxycycline 100 mg orally or IV every 12 hours
(oral form is preferable because of the irritant qualities of the IV solution)
Regimen 2 • Clindamycin 900 mg IV every 8 hours
plus
• Gentamicin loading dose IV or IM injection (2 mg/kg of body weight)
followed by maintenance dose (1.5 mg/kg) IV every 8 hours or 5-7 mg/kg IV daily
Alternative Parenteral Regimens
Regimen 1 •
or
Ofloxacin* 400 mg IV every 12 hours
• Levofloxacin* 500 mg IV daily
with or without
• Metronidazole 500 mg IV every 8 hours
Regimen 2 • Ampicillin/Sulbactam 3 g IV every 6 hours
plus
• Doxycycline 100 mg orally or IV every 12 hours (oral form is preferable due to the irritant qualities of IV solution)
* Fluoroquinolones should not be used to treat PID infections acquired outside the United States, or in California, Hawaii, or other areas with high rates of fluoroquinolone-resistant gonorrhea.