Recommendations and Rationale for the Treatment of Pelvic Inflammatory Disease

Oluwatosin Jaiyeoba; Gweneth Lazenby; David E Soper


Expert Rev Anti Infect Ther. 2011;9(1):61-70. 

In This Article

Etiology of PID

The microbial etiology of PID has been defined by investigators using endometrial biopsy, culdocentesis and laparoscopy to assess the presence of pathogens in upper genital tract sites, the endometrium, fallopian tube and peritoneal cavity (cul-de-sac). Neisseria gonorrhoeae, C. trachomatis and Mycoplasma genitalium have all been recovered from the cervix, endometrium and fallopian tube of women with laparoscopically proven acute salpingitis.[5–8] In addition, a polymicrobial flora was documented in these sites consisting of microorganisms such as Prevatella sp. and Peptostreptococcus sp. These microorganisms have also been noted to be associated with histologic evidence of inflammation (endometritis) in asymptomatic women harboring the microorganism in their cervix or with evidence of bacterial vaginosis (BV).[9] The microorganisms isolated from women with TOAs reflect the facultative and aerobic microorganisms and commonly include Escherichia coli and anaerobic Gram-negative rods. The choice of an antibiotic regimen should reflect our current knowledge of the microbial etiology of PID and offer broad-spectrum coverage of these microorganisms.


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