Medication or Drug Class




Cefoxitin or cefotetan and doxycycline

100 mg q 12 hours PO X 10-14 days

Cephalosporin, second-generation Cephalosporin, second-generation Tetracycline antibiotic

Inpatient treatment recommended by the Centers for Disease Control and Prevention (CDC)

Clindamycin and gentamycin

900 mg IV q 8 hr 2 mg/kg IV or IM loading dose, then 1.5 mg/kg q 8 hr


Antibiotic, aminoglycoside

Inpatient treatment recommended by the CDC

Two outpatient oral/oral-parenteral antibiotic regimens are also newly recommended by the CDC: (1) ofloxacin 400 mg by mouth (PO) twice a day for 14 days or levofloxacin 500 mg PO daily for 14 days with or without metronidazole 500 mg PO twice a day for 14 days; or (2) cef-triaxone 250 mg intramuscular (IM) single dose or cefoxitin 2 g IM single dose and probenecid 1 g PO plus doxycycline 100 mg PO twice a day for 14 days with or without metronidazole 500 mg PO twice a day for 14 days.


Monitor vital signs and the patient's symptoms to evaluate the course of the infection and its response to treatment. Always follow universal precautions; ensure that any item used by the patient is carefully disinfected. Provide perineal care every 2 to 4 hours with warm, soapy water to keep the area clean. Teach the patient that she needs to do these procedures as well. Allow the patient time to express her concerns. If appropriate, include the woman's partner in a question-and-answer session about the couple's potential to have children. Note that the inability to bear children is a severe loss for most couples, and they may need a referral for counseling.

Interventions that can help relieve pain include having the patient lie on her side with the knees flexed toward the abdomen. Massaging the lower back also increases her comfort. Use diversions such as music, television, and reading to take the patient's mind off the discomfort.

Peptic Ulcer Disease 709

Teach the patient interventions to prevent the recurrence of PID: to use condoms, to have all current sexual partners examined, to wash hands before changing pads or tampons, and to wipe the perineum from front to back. Encourage her to obtain immediate medical attention if fever, increased vaginal discharge, or pain occurs. Discuss with the patient when sexual intercourse or douching may be resumed (usually at least 7 days after hospital discharge).

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