Journal Article

Anaerobes in Pelvic Inflammatory Disease: Implications for the Centers for Disease Control and Prevention's Guidelines for Treatment of Sexually Transmitted Diseases

Cheryl K. Walker, Kimberly A. Workowski, A. Eugene Washington, David Soper and Richard L. Sweet

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 28, issue Supplement_1, pages S29-S36
Published in print January 1999 | ISSN: 1058-4838
Published online January 1999 | e-ISSN: 1537-6591 | DOI: https://dx.doi.org/10.1086/514720
Anaerobes in Pelvic Inflammatory Disease: Implications for the Centers for Disease Control and Prevention's Guidelines for Treatment of Sexually Transmitted Diseases

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In preparing the 1998 sexually transmitted disease treatment guidelines of the Centers for Disease Control and Prevention, we reviewed evidence regarding the need to eradicate anaerobes when treating pelvic inflammator disease (PID). Anaerobes are present in the upper genital tract during an episode of acute PID, with the prevalence dependent on the population under study. Vaginal anaerobes can facilitate acquisition of PID and cause tissue damage to the fallopian tube, either directly or indirectly through the host inflammator response. Use of several broad-spectrum regimens appears to result in excellent clinical cure rates, despite the fact that some combinations fall short of providing comprehensive coverage of anaerobes. There are limited data on the long-term effects of failing to eradicate anaerobes from the upper genital tract. Concern that tissue damage may continue when anaerobes are suboptimally treated has prompted many experts to caution that therapeutic regimens should include comprehensive anaerobic coverage for optimal treatment of women with PID.

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Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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