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Pelvic inflammatory diseases: Updated French guidelines.
J Gynecol Obstet Hum Reprod. 2020 May; 49(5):101714.JG

Abstract

Pelvic inflammatory diseases (PID) must be suspected when spontaneous pelvic pain is associated with induced adnexal or uterine pain (grade B). Pelvic ultrasonography is necessary to rule out tubo-ovarian abscess (TOA) (grade C). Microbiological diagnosis requires endocervical and TOA sampling for molecular and bacteriological analysis (grade B). First-line treatment for uncomplicated PID combines ceftriaxone 1 g, once, IM or IV, doxycycline 100 mg ×2/day, and metronidazole 500 mg ×2/day PO for 10 days (grade A). First-line treatment for complicated PID combines IV ceftriaxone 1-2 g/day until clinical improvement, doxycycline 100 mg ×2/day, IV or PO, and metronidazole 500 mg ×3/day, IV or PO for 14 days (grade B). Drainage of TOA is indicated if the pelvic fluid collection measures more than 3 cm (grade B). Follow-up is required in women with sexually transmitted infections (STIs) (grade C). The use of condoms is recommended (grade B). Vaginal sampling for microbiological diagnosis is recommended 3-6 months after PID (grade C), before the insertion of an intrauterine device (grade B), and before elective termination of pregnancy or hysterosalpingography. When specific bacteria are identified, antibiotics targeted at them are preferable to systematic antibiotic prophylaxis.

Authors+Show Affiliations

Service de Chirurgie Gynécologique et Médecine de la Reproduction, Centre Aliénor d'Aquitaine, Hôpital Pellegrin, CHU de Bordeaux, Place Amélie Raba Léon, 33076 Bordeaux, France. Electronic address: jean-luc.brun@chu-bordeaux.fr.Antenne de Conseil en Infectiologie Départementale, 80 avenue Georges Pompidou, 24000 Périgueux, France.Centre National de Référence des Infections Sexuellement Transmissibles bactériennes, CHU de Bordeaux, Place Amélie Raba Léon, 33076 Bordeaux, France.Centre National de Référence des Infections Sexuellement Transmissibles bactériennes, CHU de Bordeaux, Place Amélie Raba Léon, 33076 Bordeaux, France.Service de Gynécologie-Obstétrique et Médecine de la Reproduction, CHU de Poitiers, 2 rue de la Milétrie, 86000 Poitiers, France.Service des Maladies Infectieuses, CHRU de Lille, 2 avenue Oscar Lambret, 59000 Lille, France.Service de Gynécologie-Obstétrique et Médecine de la Reproduction, CHU de Poitiers, 2 rue de la Milétrie, 86000 Poitiers, France.Service de Maladies Infectieuses et Tropicales, CHRU de Caen, avenue de la côte de Nacre, 14000 Caen, France.Service de Gynécologie-Obstétrique et Médecine de la Reproduction, CHU de Poitiers, 2 rue de la Milétrie, 86000 Poitiers, France.Service de Gynécologie-Obstétrique, Institut Mère Enfant Alix de Champagne, 45 rue Cognacq-Jay, 51092 Reims, France.Collège National des Gynécologues et Obstétriciens Français (CNGOF), 91 boulevard Sébastopol, 75002 Paris, France.Société de Pathologie Infectieuse de Langue Française (SPILF), 21 rue Beaurepaire, 75010 Paris, France.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

32087306

Citation

Brun, Jean-Luc, et al. "Pelvic Inflammatory Diseases: Updated French Guidelines." Journal of Gynecology Obstetrics and Human Reproduction, vol. 49, no. 5, 2020, p. 101714.
Brun JL, Castan B, de Barbeyrac B, et al. Pelvic inflammatory diseases: Updated French guidelines. J Gynecol Obstet Hum Reprod. 2020;49(5):101714.
Brun, J. L., Castan, B., de Barbeyrac, B., Cazanave, C., Charvériat, A., Faure, K., Mignot, S., Verdon, R., Fritel, X., & Graesslin, O. (2020). Pelvic inflammatory diseases: Updated French guidelines. Journal of Gynecology Obstetrics and Human Reproduction, 49(5), 101714. https://doi.org/10.1016/j.jogoh.2020.101714
Brun JL, et al. Pelvic Inflammatory Diseases: Updated French Guidelines. J Gynecol Obstet Hum Reprod. 2020;49(5):101714. PubMed PMID: 32087306.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pelvic inflammatory diseases: Updated French guidelines. AU - Brun,Jean-Luc, AU - Castan,Bernard, AU - de Barbeyrac,Bertille, AU - Cazanave,Charles, AU - Charvériat,Amélie, AU - Faure,Karine, AU - Mignot,Stéphanie, AU - Verdon,Renaud, AU - Fritel,Xavier, AU - Graesslin,Olivier, AU - ,, AU - ,, Y1 - 2020/02/20/ PY - 2019/11/02/received PY - 2020/02/03/accepted PY - 2020/2/23/pubmed PY - 2021/3/12/medline PY - 2020/2/23/entrez KW - Antibiotics KW - Bacteriological sampling KW - Follow-up KW - Pelvic inflammatory disease KW - Tubo-ovarian abscess SP - 101714 EP - 101714 JF - Journal of gynecology obstetrics and human reproduction JO - J Gynecol Obstet Hum Reprod VL - 49 IS - 5 N2 - Pelvic inflammatory diseases (PID) must be suspected when spontaneous pelvic pain is associated with induced adnexal or uterine pain (grade B). Pelvic ultrasonography is necessary to rule out tubo-ovarian abscess (TOA) (grade C). Microbiological diagnosis requires endocervical and TOA sampling for molecular and bacteriological analysis (grade B). First-line treatment for uncomplicated PID combines ceftriaxone 1 g, once, IM or IV, doxycycline 100 mg ×2/day, and metronidazole 500 mg ×2/day PO for 10 days (grade A). First-line treatment for complicated PID combines IV ceftriaxone 1-2 g/day until clinical improvement, doxycycline 100 mg ×2/day, IV or PO, and metronidazole 500 mg ×3/day, IV or PO for 14 days (grade B). Drainage of TOA is indicated if the pelvic fluid collection measures more than 3 cm (grade B). Follow-up is required in women with sexually transmitted infections (STIs) (grade C). The use of condoms is recommended (grade B). Vaginal sampling for microbiological diagnosis is recommended 3-6 months after PID (grade C), before the insertion of an intrauterine device (grade B), and before elective termination of pregnancy or hysterosalpingography. When specific bacteria are identified, antibiotics targeted at them are preferable to systematic antibiotic prophylaxis. SN - 2468-7847 UR - https://www.unboundmedicine.com/medline/citation/32087306/Pelvic_inflammatory_diseases:_Updated_French_guidelines. L2 - https://linkinghub.elsevier.com/retrieve/pii/S2468-7847(20)30044-1 DB - PRIME DP - Unbound Medicine ER -