An audit on the management of pelvic inflammatory disease in the West Midlands, UK

Abstract

The potential complications of pelvic inflammatory disease (PID) make optimizing its management a high priority. A clinical audit of PID against current national management guidelines was conducted in 14 departments of genitourinary medicine in the West Midlands for women presenting with PID between January and December 2005. There were a total of 810 diagnoses of PID made from a total of 49,390 female attendees for that year, giving an incidence of 164 cases per 10,000 attendees. Of these 810 cases, data collection and analysis for this audit were performed on 139. An ofloxacin 400 mg twice daily (b.i.d.) based regimen was prescribed in 91 (65%, 95% confidence interval [CI] 57-73%) cases. Doxycycline 100 mg b. i. d. for 14 days plus metronidazole 400 mg b. i. d. for 5-14 days was prescribed in 44 (32%, 95% CI 25-40%) cases, but a third-generation cephalosporin was only given with this regimen in three cases. Partner notification was performed in 101 (73%, 95% CI 65-79%) cases. A total of 130 male contacts were recorded on the data collection forms, and of these 58 (45%) were traced and 51 (39%), treated. A follow-up appointment was given to 133 (96%, 95% CI 91-98%) women, although in most cases this was for seven days or more, and 104 (78%, 95% CI 67-81%) women attended for follow-up. Adherence to the national guidelines in this cohort of patients did not reach the national standard for choice of treatment regimen nor did it attain the target for proportion of male partners traced. Barriers preventing adherence to the national guidelines need to be explored and appropriate assistance given to physicians to help meet national standards of care.