Pelvic inflammatory diseases: updated French guidelines.
Fiche publication
Date publication
février 2020
Journal
Journal of gynecology obstetrics and human reproduction
Auteurs
Membres identifiés du Cancéropôle Est :
Pr GRAESSLIN Olivier
Tous les auteurs :
Brun JL, Castan B, de Barbeyrac B, Cazanave C, Charvériat A, Faure K, Mignot S, Verdon R, Fritel X, Graesslin O, ,
Lien Pubmed
Résumé
Pelvic inflammatory diseases (PID) must be suspected when spontaneous pelvic pain is associated with induced adnexal or uterine pain (grade B). Pelvic ultrasonography is necessary to rule out tubo-ovarian abscess (TOA) (grade C). Microbiological diagnosis requires endocervical and TOA sampling for molecular and bacteriological analysis (grade B). First-line treatment for uncomplicated PID combines ceftriaxone 1 g, once, IM or IV, doxycycline 100 mg ×2/day, and metronidazole 500 mg ×2/day PO for 10 days (grade A). First-line treatment for complicated PID combines IV ceftriaxone 1 to 2 g/day until clinical improvement, doxycycline 100 mg ×2/day, IV or PO, and metronidazole 500 mg ×3/day, IV or PO for 14 days (grade B). Drainage of TOA is indicated if the pelvic fluid collection measures more than 3 cm (grade B). Follow-up is required in women with sexually transmitted infections (STIs) (grade C). The use of condoms is recommended (grade B). Vaginal sampling for microbiological diagnosis is recommended 3 to 6 months after PID (grade C), before the insertion of an intrauterine device (grade B), and before elective termination of pregnancy or hysterosalpingography. When specific bacteria are identified, antibiotics targeted at them are preferable to systematic antibiotic prophylaxis.
Mots clés
Antibiotics, Bacteriological sampling, Follow-up, Pelvic inflammatory disease, Tubo-ovarian abscess
Référence
J Gynecol Obstet Hum Reprod. 2020 Feb 19;:101714