Upper and lower reproductive tract bacteria in 126 women with acute pelvic inflammatory disease. Microbial susceptibility and clinical response to four therapeutic regimens

To more clearly understand the microbiology of acute salpingitis in our patients and to evaluate the clinical efficacy and safety of recommended and new therapeutic regimens, 126 women who met clinical diagnostic criteria for acute community-acquired pelvic inflammatory disease underwent endocervical and endometrial cultures prior to random intravenous therapy with cefoxitin plus doxycycline, ceftizoxime plus doxycycline or ceftizoxime alone (two regimens). Nine women (7%) had Chlamydia, and 70 (56%) had gonococci in endometrial specimens (P < .001). Only two women (3.4%) given monotherapy required altered medical therapy, and none required surgery. Parenteral combination therapy was associated more frequently with adverse clinical and laboratory events.