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At least 19 recordsLinked to original sources
PubMed1987

Piperacillin and a combination of clindamycin and gentamicin for the treatment of hospital and community acquired acute pelvic infections including pelvic abscess.

Therapy for acute polymicrobial pelvic infections is empiric and must include predictable anaerobic coverage. Single agent therapy, if effective, is advantageous for the patient, nurses, pharmacy and hospital. Piperacillin sodium was compared with a combination of clindamycin and gentamicin as therapy for 63 female patients who were hospitalized with acute pelvic infections including pelvic abscess complicating community acquired salpingitis. Over-all clinical efficacy with piperacillin was 96.8 per cent and 90.3 per cent for clindamycin and gentamicin. Fewer bacteria demonstrated in vitro resistance to piperacillin (p = 0.008) and the cost of treatment for these infections was significantly less with piperacillin (p less than 0.05). Serious adverse reactions were not observed with either regimen. Piperacillin provides effective, cost-efficient therapy for women with acute polymicrobial pelvic infections.

Abscess↗
PubMed1993

Relationship of pelvic infection and chronic pelvic pain.

The approach to the patient with CPP with a history of PID remains a diagnostic challenge even for the experienced clinician. From the initial diagnosis of presumed PID to managing the pain that may result, using an approach that looks at all factors, not just antecedent PID, allows the practicing physician to avoid becoming too narrowly focused in his or her approach. A clinical starting point would assume all possibilities for pelvic pain and evaluate for each. Given the history of one or more episodes of PID, especially if documented with a prior laparoscopy, earlier investigation for adhesions could be justified in selected patients. If the pelvic examination further suggests a pelvic source, a laparoscopy performed early rather than late in the work-up would seem appropriate. The key to management of the patients who have CPP following PID is to use any and all available diagnostic and therapeutic modalities to identify the source(s) before assuming that the patient suffers only from the known sequelae of PID.

Chronic Disease↗
PubMedDate not supplied

Preventing pelvic infection after abortion.

Pelvic infection is the commonest complication of legal abortion. The presence of lower genital tract infections increases the risk of complications, and women requesting abortion are at significant risk of harbouring sexually transmitted diseases (STD). Prophylactic antibiotic treatment can decrease the rate of post-abortal sepsis, but the optimum regime is unclear. In particular, patients with Chlamydia trachomatis infection, and bacterial vaginosis would appear to be at increased risk, and detection and treatment of these conditions can lower this risk. The opportunity to screen and treat for STD presents itself in this setting, allowing patients and their sexual contacts to benefit, with a decrease in the infected pool in the community.

Abortion, Legal↗
PubMed1992

Evaluation of new anti-infective drugs for the treatment of acute pelvic infections in hospitalized women. Infectious Diseases Society of America and the Food and Drug Administration.

This set of guidelines deals with evaluation of anti-infective drugs for treatment of acute pelvic infections in hospitalized women. The clinical entities include infectious complications of cesarean section; elective hysterectomy; and septic, incomplete abortion. Conditions including endomyometritis, cuff cellulitis, pelvic cellulitis, parametritis, phlegmon, and pelvic abscesses may arise due to a variety of bacterial species, both aerobic and anaerobic, that comprise the endogenous flora of the lower reproductive tract. Anaerobic bacteria have assumed particular importance, and therapy should be directed against such organisms. The roles of enterococci, chlamydiae, and mycoplasmas remain uncertain. Culture samples must be obtained under conditions assuring minimal vaginal contamination. Before a new drug may be used for treatment of human pelvic infections, considerable information is necessary about its antimicrobial spectrum as well as its safety and efficacy. Placebo-controlled trials are considered unethical. Historical controls may be used, but concurrent active control comparative trials are preferred. Parenteral administration is recommended for at least the initial 4 days of therapy, but orally administered drugs may be evaluated for completion of longer courses. The expected cure rate is approximately 90%. Uncomplicated infections should be treated for at least 4 days; more complicated infections may require prolonged therapy. Although clinical cure is paramount, microbiologic response must also be taken into account. In the final assessment, outcome will be classified as cure, failure, or indeterminate.

Acute Disease↗
PubMed1988

Surgical approaches to pelvic infections in women.

Pelvic abscess is a complication of gynecologic disease or obstetric surgery. Tuboovarian complex is differentiated from abscesses because of the absence of a true abscess wall; treatment of a tuboovarian complex is conservative. The diagnosis of tuboovarian complex is made by history, pelvic examination and ultrasonography. Tuboovarian abscesses (TOAs) are sequelae of surgical procedures. Both conventional and novel surgical techniques can be used to manage them. Pelvic thrombophlebitis and ovarian vein thrombosis are late complications of pelvic infections that may be associated with significant morbidity and mortality.

Abscess↗
PubMed1985

The next 10 years in the treatment of pelvic infections.

The future developments in the treatment of pelvic infections in women are based on recent changes. There is an expanded knowledge of the complex multibacterial nature of pelvic infections, the clinical view of salpingitis has radically changed, and there have been great modifications in antibiotic treatment strategies with particular emphasis on anaerobes and Chlamydia. In the next 10 years, the following new developments may be expected. In the diagnosis of pelvic infection, there will be new efforts to have better clinical tests and the use of nonspecific and specific laboratory tests. The rapid identification of Neisseria gonorrhea, group B beta-hemolytic Streptococcus, Chlamydia, and Bacteroides fragilis would be an important laboratory aid. The treatment of pelvic infection will not be significantly altered by the introduction of new antibiotics. There will be an emphasis on new combinations of currently available antibiotics and studies that focus on the long-term follow-up of treated patients. In the understanding of the pathophysiology of pelvic infections, the importance of the spermatozoa as a carrier of bacteria and the potent immunosuppression due to seminal fluid will be investigated in detail, along with a greater emphasis on treatment of the male.

Anti-Bacterial Agents↗
PubMed1987

Antibiotic treatment for pelvic infection.

Antibiotic strategies for pelvic infections in the 1980s are much more complex, because of the variety of bacteria involved, aerobes, anaerobes and Chlamydia. There is a difference in the clinical response of patients treated with early or well-established infections. In well established infections, patients with a pelvic mass or symptoms greater than five days, the failure rate of antibiotic treatment is higher and operative intervention to drain or remove an abscess is more frequently needed. Physicians need to know the antibiotic susceptibilities of Bacteroides fragilis and the activity of antibiotics against this species when large numbers of bacteria are present. In patients seen early in the course of infection, antibiotics effective against gram-negative anaerobes are helpful, particularly in the patient with an endomyometritis following cesarean section.

Animals↗
PubMed1985

Patient cost in the treatment of postsurgical female pelvic infection.

Soft tissue female pelvic infections, that is, postpartum endomyometritis, pelvic cellulitis, and salpingitis, are frequently polymicrobial, involving aerobic and anaerobic bacteria. The most common antibiotic regimen employed for the treatment of these patients is clindamycin and an aminoglycoside. Single-agent therapy, utilizing the newer beta-lactams, is more economical, potentially less toxic, and as effective.

Anti-Bacterial Agents↗
PubMed1982

Severe pelvic infection from Chlamydia trachomatis after cesarean section.

A severe pelvic infection developed in a 17-year-old primigravida after a cesarean section. Multiple antibiotics were administered for presumed mixed aerobic and anaerobic infections, without improvement. Subsequently, total hysterectomy and bilateral salpingo-oophorectomy were performed. Despite negative standard cultures, her condition continued to deteriorate and she required two more exploratory laparotomies for suspected intra-abdominal abscesses. Chlamydia trachomatis and, subsequently, Candida albicans were recovered from cultures of peritoneal fluid obtained after the third operation. Serological tests confirmed the presence of acute chlamydial infection. Marked clinical improvement occurred after doxycycline hyclate administration. Although genitourinary and acute pelvic inflammatory diseases due to chlamydiae have been reported previously, no case of severe pelvic infection due to this agent after cesarean section had been described, to our knowledge. Specimens should be studied specifically for chlamydiae when standard cultures demonstrate no pathogens in women suffering from documented pelvic infection.

Abdomen↗
PubMed1990

Ticarcillin/clavulanate. An alternative to combination antibiotic therapy for treating soft tissue pelvic infections in women.

Soft tissue pelvic infections--i.e., postpartum endometritis, endometritis, pelvic inflammatory disease and pelvic cellulitis--are predominantly polymicrobial. The microflora of these infections consists of a mixture of gram-positive and -negative bacteria, including aerobes and facultative and obligate anaerobes. Clindamycin plus gentamicin has been the principal antibiotic combination utilized for treatment of these infections. Ticarcillin/clavulanate appears to be an excellent replacement for initiating empiric therapy for these infections because of its safety and broad spectrum of activity, which includes gram-negative and -positive aerobic and anaerobic bacteria.

Bacterial Infections↗
PubMed1987

Single-agent therapy for women with acute polymicrobial pelvic infections.

Pathogens that cause acute polymicrobial female pelvic infections usually do not differ from those that compose the normal flora of the lower reproductive tract. Accurate identification of these bacteria is difficult because cultures obtained via the lower tract can easily be contaminated. Although use of a double-lumen catheter-protected brush culture cannot completely eliminate the risk of contamination, it is the least invasive method for obtaining culture material from the upper reproductive tract. Compounding the problem of accurately identifying pathogens that cause acute upper tract infections is the fact that bacteria appear to be present in the upper tracts of asymptomatic women with normal examinations. Because of these problems and because of the polymicrobial nature of these infections, empiric therapy frequently includes more than one antimicrobial agent. Newer, semisynthetic penicillins and cephalosporins have expanded spectrums of in vitro activity against most of the bacteria frequently recovered from pelvic infection sites. Comparative clinical trials have shown these agents to be as effective when used alone as is combination therapy. With few exceptions, empiric monotherapy with one of these newer antimicrobials will be curative for women with acute upper tract infection, will have less potential toxicity, will require less space, materials, and manpower to administer, and will be less expensive.

Anti-Bacterial Agents↗
PubMed1988

Antibiotic usage in pelvic infections. An overview.

Postoperative soft-tissue pelvic infections in women most commonly are polymicrobial and mixed aerobic and anaerobic. Antibiotic prophylaxis has been advocated to reduce the risk of postcesarean endometritis and post-vaginal hysterectomy pelvic infection. The use of antibiotic prophylaxis has a tendency to select for resistant bacteria, and many of those bacteria produce beta-lactamase. A new approach to the treatment of those infections is to employ beta-lactamase inhibitors in conjunction with a broad-spectrum antibiotic, such as ticarcillin disodium plus clavulanate potassium (Timentin).

Anti-Bacterial Agents↗
PubMed1993

Acute pelvic infection following hysterosalpingography at the Kenyatta National Hospital, Nairobi.

A total of 150 women who had hysterosalpingography (HSG) for investigation of infertility, at the Kenyatta National Hospital over a five month period, were recruited into the study to determine the prevalence of pelvic infection following the procedure. 44.0% of the total study group developed pelvic infection disease (PID) within the first week after the procedure. There were no obvious determining factors. It is possible that most women with infertility have quiescent genital tract infection, prior to HSG, with the latter only facilitating the entry of micro-organisms into the upper genital tract, thus causing pelvic infection or reactivating a pre-existing infections. Further studies should be conducted to determine the microbial patterns of the infection. There should be routine provision of prophylactic antimicrobial agent(s) to all women undergoing HSG in our unit to minimise the risk of developing pelvic infection and further damage to the uterine tubes which will worsen the prognosis.

Adolescent↗
PubMedDate not supplied

[Pelvic infection: diagnostic and therapeutic approach].

Pelvic infection is one of the most frequent diseases in the developing countries. Without laparoscopy, diagnosis based on number of symptoms and present clinical manifestations can be established. Each step (uncomplicated salpingitis, salpingo-peritonitis, pelvic abscess, ruptured abscess) implies a specific curative target with levels of care, surgical treatment and antibiotic therapy adapted to it.

Female↗
PubMed1980

Pelvic infections following gynecologic procedures in Bangladesh.

Data were collected to establish the rate of pelvic infection following various gynecologic procedures, including postpartum intrauterine device (IUD) insertions, IUD insertion following menstrual regulation procedures, IUD insertion in women who were not recently pregnant, and induced and spontaneous abortions. The pelvic infection rate was only 1% in 97 women who underwent postpartum IUD insertions. The infection rate was related to the timing of IUD insertion and the type of IUD used. Finally, the pelvic infection rate was unacceptably high (10.3%) in women undergoing induced abortions vs. women having spontaneous abortions (1.1%).

Abortion, Induced↗