Pelvic Inflammatory Disease (PID)

Important: Therapy

For mild to moderate PID (no fever, systemically well)

Doxycycline oral 100mg 12 hourly

Plus

Metronidazole oral 400mg 12 hourly

 

If doxycycline contraindicated

Ofloxacin oral 400mg 12 hourly

Plus

Metronidazole oral 400mg 12 hourly

 

For moderate to severe PID or where there is a high risk of gonococcal infection

Ceftriaxone IM 1g single dose followed by:

Doxycycline oral 100mg 12 hourly plus Metronidazole oral 400mg 12 hourly

Important: Therapy

First line if able to tolerate oral medication

Ceftriaxone IV 2g daily

Plus

Doxycycline oral 100mg 12 hourly

Plus

Metronidazole oral 400mg 12 hourly

Review ceftriaxone daily and STOP 24 hours after clinical improvement - single dose treatment acceptable

Second line treatment (severe penicillin or cephalosporin allergy or oral route not available or doxycycline contraindicated)

Ciprofloxacin IV 400mg 12 hourly

plus

Metronidazole IV  500mg 8 hourly

If signs of sepsis with organ dysfunction:

Add Vancomycin IV (dosing as per guideline. Use vancomycin calculator