Effectiveness of Doxycycline as Monotherapy for the Treatment of Acute Pelvic Inflammatory Disease resistant with Traditional Combined Regimen / 대한산부인과학회지

ABSTRACT

OBJECTIVE: To evaluate the effectiveness of doxycycline as monotherapy for the treatment of acute pelvic inflammatory disease (AcPID) resistant with traditional combined regimen (TCR). METHODS: 128 patients were selected, who were diagnosed as AcPID from January 2003 to June 2004 and prescribed with medical treatment. Initially, TCR by cephalosporin, metronidazole, and aminoglycoside antibiotics was applied to all patients. 2-3 days later, the level of subjective pain or tenderness on pelvic examination was evaluated. If it is 30% or less than initial symptoms and signs, original regimen was prescribed (group I). If it is 30% more than initial symptoms and signs, we judged AcPID resistant with TCR and changed the antibiotic regimen with doxycycline (group II). Cure of AcPID was defined by no pain or tenderness. In this study, retrospective review about the result of medical treatment and clinical characteristics between two groups was done. RESULTS: Of the 128 patients, 94 (73.4%) was group I (46 inpatient and 48 outpatient) and 34 (26.6%) was group II (20 and 14). There were no significant differences in clinical characteristics except initial blood WBC count between group I and II. Initial blood WBC count was 11153+/-4393/microliter in group I and 9112+/-3483/microliter in group II (p<0.05). Positive rate of Chlamydia trachomatis using PCR was 9.4% (12/128) in all patients (group I:0%, II:35.3%). All patients of two groups were cured with TCR and doxycycline. CONCLUSION: Our data shows that doxycycline as monotherapy is effective to patients who are resistant with TCR for medical treatment of AcPID.