Titre du document / Document title

Medically sound, cost-effective treatment for pelvic inflammatory disease and tuboovarian abscess. Discussion

Auteur(s) / Author(s)

MCNEELEY S. G. ⁽¹⁾ ; HENDRIX S. L. ⁽¹⁾ ; MAZZONI M. M. ⁽¹⁾ ; KMAK D. C. ⁽¹⁾ ; RANSOM S. B. ⁽¹⁾ ; LEVINE E. (Commentateur) ; GARCIA P. (Commentateur) ; MOU S. M. (Commentateur) ; RIDER J. (Commentateur) ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Hutzel Hospital, ETATS-UNIS

Résumé / Abstract

OBJECTIVE: Our purpose was to determine the clinical effectiveness and cost-effectiveness of three antibiotic regimens for the treatment of pelvic inflammatory disease and tuboovarian abscess. STUDY DESIGN: A review of all patients' hospitalized at Hutzel Hospital, Detroit, Michigan, for treatment of pelvic inflammatory disease and tuboovarian abscess between Jan. 1, 1993, and April 30, 1997, was performed. Demographic data, antibiotic choices, changes in therapy, operative interventions, and cost of therapy were assessed. RESULTS: Two hundred three patients were admitted for treatment of pelvic inflammatory disease during the study period. We were able to evaluate the clinical efficacy of antibiotic treatment in 179 patients, including 105 patients with pelvic inflammatory disease alone (uncomplicated pelvic inflammatory disease) and 74 women whose infection was complicated by tuboovarian abscess. The three antibiotic regimens evaluated were cefotetan plus doxycycline, clindamycin plus gentamicin, and ampicillin plus clindamycin plus gentamicin. All regimens demonstrated comparable efficacy in treating uncomplicated genital tract infections. Ampicillin plus clindamycin plus gentamicin was significantly better than clindamycin plus gentamicin and cefotetan plus doxycycline in treatment of tuboovarian abscess (p = 0.001). Fifteen women with tuboovarian abscess responded to a change to ampicillin plus gentamicin plus clindamycin antibiotic therapy alone. The hospital stay was prolonged by approximately 3 days in women failing to respond to initial antibiotic therapy, and operative interventions were common in this group of patients. CONCLUSIONS: Cefotetan plus oral doxycycline is the most cost-effective regimen for treating uncomplicated pelvic inflammatory disease, whereas triple-antibiotic therapy is the treatment of choice in women with tuboovarian abscess.

Revue / Journal Title

American journal of obstetrics and gynecology   ISSN 0002-9378   CODEN AJOGAH 

Source / Source

Congrès
Annual Meeting of The Central Association of Obstetricians and Gynecologists N^o65, Scottsdale, Arizona , ETATS-UNIS (29/10/1997)
1998, vol. 178, n^o6, pp. 1272-1278 (12 ref.)

Langue / Language

Anglais

Editeur / Publisher

Elsevier, Philadelphia, PA, ETATS-UNIS  (1920) (Revue)

Mots-clés anglais / English Keywords

Abscess ; Adnexa uteri ; Complication ; Inflammatory disease ; Pelvic cavity ; Comparative study ; Cefotetan ; Chemotherapy ; Treatment ; Doxycycline ; Combined treatment ; Treatment efficiency ; Gentamicin ; Clindamycin ; Ampicillin ; United States ; Adult ; Female ; Cephalosporin derivatives ; Tetracycline derivatives ; Aminoglycoside ; North America ; America ; Human ; Adnexal diseases ; Female genital diseases ; Infection ; Pelvis pathology ; Antibiotic ; Antibacterial agent ; Penicillin derivatives ;

Mots-clés français / French Keywords

Abcès ; Annexe utérine ; Complication ; Maladie inflammatoire ; Cavité pelvienne ; Etude comparative ; Céfotétan ; Chimiothérapie ; Traitement ; Doxycycline ; Traitement associé ; Efficacité traitement ; Gentamicine ; Clindamycine ; Ampicilline ; Etats Unis ; Adulte ; Femelle ; Céphalosporine dérivé ; Tétracycline dérivé ; Aminoglycoside ; Amérique du Nord ; Amérique ; Homme ; Annexe utérine pathologie ; Appareil génital femelle pathologie ; Infection ; Pelvis pathologie ; Antibiotique ; Antibactérien ; Pénicilline dérivé ;

Mots-clés espagnols / Spanish Keywords

Absceso ; Anexo uterino ; Complicación ; Enfermedad inflamatoria ; Cavidad pelviana ; Estudio comparativo ; Cefotetán ; Quimioterapia ; Tratamiento ; Doxiciclina ; Tratamiento asociado ; Eficacia tratamiento ; Gentamicina ; Clindamicina ; Ampicilina ; Estados Unidos ; Adulto ; Hembra ; Cefalosporina derivado ; Tetraciclina derivado ; Aminoglicósido ; America del norte ; America ; Hombre ; Anexo uterino patología ; Aparato genital hembra patología ; Infección ; Pelvis patología ; Antibiótico ; Antibacteriano ; Penicilinas ;

Localisation / Location

INIST-CNRS, Cote INIST : 3053, 35400007709745.0250