Duration

14 days (total duration IV plus oral)

Outpatient Therapy for Pelvic Inflammatory Disease (PID)

Important: Therapy

For mild to moderate PID (no fever, systemically well)

Doxycycline oral 100mg 12 hourly

Plus

Metronidazole oral 400mg 12 hourly

 

If doxycycline contraindicated

Ofloxacin oral 400mg 12 hourly

Plus

Metronidazole oral 400mg 12 hourly

 

For moderate to severe PID or where there is a high risk of gonococcal infection

Ceftriaxone IM 1g single dose followed by:

Doxycycline oral 100mg 12 hourly plus Metronidazole oral 400mg 12 hourly

Notes:

Inpatient Therapy for moderate to severe PID

Important: Therapy

First line if able to tolerate oral medication

Ceftriaxone IV 2g daily

Plus

Doxycycline oral 100mg 12 hourly

Plus

Metronidazole oral 400mg 12 hourly

Review ceftriaxone daily and STOP 24 hours after clinical improvement - single dose treatment acceptable

Second line treatment (severe penicillin or cephalosporin allergy or oral route not available or doxycycline contraindicated)

Ciprofloxacin IV 400mg 12 hourly

plus

Metronidazole IV  500mg 8 hourly

If signs of sepsis with organ dysfunction:

Add Vancomycin IV (dosing as per guideline. Use vancomycin calculator.

Notes:

Important: Notes

See NHS Borders Sexual Health STI protocols for more details http://www.borderssexualhealth.org.uk/for-professionals/clinical-protocols/

Fluroquinolones

Refer to important safety information for all quinolones prior to prescribing.

See MHRA Drug Safety Update January 2024: Fluoroquinolones must only be used in situations when other antibiotics, that are commonly recommended for the infection, are inappropriate such as:

  • there is resistance to other first-line antibiotics recommended for the infection
  • other first-line antibiotics are contraindicated in an individual patient
  • other first-line antibiotics have caused side effects in the patient requiring treatment to be stopped
  • treatment with other first-line antibiotics has failed