Do short-term markers of treatment efficacy predict long-term sequelae of pelvic inflammatory disease?

Academic Article

Abstract

  • OBJECTIVE: This study was undertaken to assess whether short-term markers, often used to measure clinical cure after treatment for pelvic inflammatory disease, predict sequelae of lack of pregnancy, recurrent pelvic inflammatory disease, and chronic pelvic pain. STUDY DESIGN: Women with mild-to-moderate pelvic inflammatory disease were assessed after treatment initiation at 5 days for tenderness (n = 713) and at 30 days for tenderness, cervical infections and endometritis (n = 298). Pregnancy, recurrent pelvic inflammatory disease, and chronic pelvic pain were evaluated after 84 months, on average. RESULTS: Pelvic tenderness at 5 and at 30 days significantly elevated the risk for developing chronic pelvic pain; tenderness at 30 days was also significantly associated with recurrent pelvic inflammatory disease. However, pelvic tenderness at 5 and at 30 days was only modestly clinically predictive of chronic pelvic pain or recurrent pelvic inflammatory disease (positive predictive values 22.1-66.9%). No short-term marker significantly influenced the likelihood of achieving a pregnancy. CONCLUSION: Tenderness at 5 or 30 days did not accurately predict the occurrence of pelvic inflammatory disease-related reproductive morbidities.
  • Authors

    Keywords

  • Administration, Oral, Adolescent, Adult, Cefoxitin, Dose-Response Relationship, Drug, Doxycycline, Drug Administration Schedule, Drug Therapy, Combination, Female, Follow-Up Studies, Humans, Infertility, Female, Inflammation Mediators, Infusions, Intravenous, Pain Measurement, Pelvic Inflammatory Disease, Predictive Value of Tests, Probability, Probenecid, Proportional Hazards Models, Recurrence, Severity of Illness Index, Time Factors, Treatment Outcome
  • Digital Object Identifier (doi)

    Pubmed Id

  • 3839474
  • Authorlist

  • Trautmann GM; Kip KE; Richter HE; Soper DE; Peipert JF; Nelson DB; Trout W; Schubeck D; Bass DC; Ness RB
  • Start Page

  • 30.e1
  • End Page

  • 30.e7
  • Volume

  • 198
  • Issue

  • 1