Pelvic inflammatory disease

An infectious and inflammatory involvement of the uterus, fallopian tubes, and ovaries that usually ascends from the lower genital tract. Severe cases are treated in hospital with intravenous antibiotics because of the risk of abscess, infertility, and ectopic pregnancy

ICD-10 N731 drug

Also known as: PID, Acute salpingitis, Upper genital tract infection

Drugs used for this condition

AGentamicinFirst line · Aminoglycoside antibioticIn severe PID treated in hospital, intravenous gentamicin is part of one of the recommended parenteral regimens, combined with clindamycin, where the aminoglycoside adds Gram-negative coverage and complements anaerobic activity. In the CDC STI Treatment Guidelines, 2021, this regimen stands alongside the cephalosporin-based regimens with no reserve designation. The 2017 Cochrane systematic review found clindamycin plus an aminoglycoside non-inferior to cephalosporins and quinolones for cure rates. Once the patient improves clinically, parenteral therapy is switched to oral treatment.

How to read tiers A–F

Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.

AStrong evidence – first or second line in international guidelines
BRecommended in selected cases
CStudy data contradict each other
DBenefit not proven, no documented harm
FDocumented harm, or risk without benefit