Small pelvic inflammatory diseases: Diagnosis and patient management tactics

Abstract

Small pelvic inflammatory diseases (endometritis, salpingitis, tubo-ovarian abscess, and pelvioperitonitis) in women of childbearing age are most common. Analysis of U.S. and European guidelines for the management of patients with small pelvic inflammatory diseases and research articles from journals has provided criteria (minimum additional, specific) for the diagnosis of these diseases, those for their out- or inpatient treatment, and principles in the treatment of these patents. The management of these patients should be comprehensive, but based on rational empiric antibiotic therapy. The general principles of antimicrobial therapy should be as follows: 1) as early onset as possible; 2) 10—14-day antibiotic use covering the full spectrum of probable causative agents; 3) outpatient oral antibiotic treatment for mild and moderate small pelvic inflammatory diseases. Only inpatient parenteral antibiotic treatment should be performed in patients with severe forms and, if their condition improves, it may be switched over to oral antibiotics in 1—2 days. The fourth-generation fluoroquinolone moxifloxacin is shown to be highly effective in treating this patient group. The authors declare no conflicts of interest.