Antimicrobial prescribing: NHS Lothian
- Vaginal swab for combined Chlamydia/Gonorrhoea NAAT test.
- Consider high vaginal swab.
- Consider HIV and syphilis testing.
Blood cultures are required for patients admitted to hospital for IV therapies
Pelvic inflammatory disease
What's new / Latest updates
Tables re-configured 11th April 2024
For full guidance see Pelvic Inflammatory Disease (PID) Guidance, Gynaecology Services Lothian (intranet only)
In pregnant or breast feeding see: Pelvic inflammatory disease in pregnancy
Recommended total duration: 14 days
Doxycycline 100mg orally every 12 hours
AND
Metronidazole 400mg orally every 12 hours
If a high risk of gonorrhoea
Ceftriaxone 1000mg IM single dose
AND
Doxycycline 100mg orally every 12 hours
AND
Metronidazole 400mg orally every 12 hours
Ceftriaxone is associated with C.difficile diarrhoea.
Recommended total duration: 14 days
| Recommended antibiotics |
Ceftriaxone 2g IV daily STOP when temperature <38oC for >24 hours and evidence of improvement of signs of sepsis, if present on admission (single dose treatment acceptable). AND Doxycycline 100mg orally every 12 hours AND Metronidazole 400mg orally every 12 hours |
|
Alternative in anaphylaxis to penicillin or cephalosporin allergy OR unable to tolerate oral medication OR doxycyline contraindicated |
Ciprofloxacin 400mg IV every 12 hours AND Metronidazole 500mg IV every 8 hours If signs of sepsis with organ dysfunction. ADD Vancomycin IV as per NHS Lothian AMT intranet calculator. |
See MHRA warning related to ciprofloxacin.
Ciprofloxacin and ceftriaxone are associated with C.difficile diarrhoea.
Doxycycline 100mg every 12 hours
AND
Metronidazole 400mg every 12 hours
Where doxycycline is contraindicated
Ofloxacin 400mg every 12 hours
AND
Metronidazole 400mg every 12 hours
See MHRA warning related to ofloxacin.
Ofloxacin is associated with C.difficile diarrhoea.
Likely organisms: Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, anaerobes