HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Savaris, R. F. Articles by Schachter, J. Search for Related Content PubMed PubMed Citation Articles by Savaris, R. F. Articles by Schachter, J. Related Collections General gynecology Infectious disease

Comparing Ceftriaxone Plus Azithromycin or Doxycycline for Pelvic Inflammatory Disease

A Randomized Controlled Trial

From the ¹Departamento e Serviço de Ginecologia e Obstetrícia, ²Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil; ³Departamento e Serviço de Patologia, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil; and ⁴Department of Laboratory Medicine, University of California, San Francisco, San Francisco, California.

OBJECTIVE: To evaluate the equivalence of ceftriaxone plus doxycycline or azithromycin for cases of mild pelvic inflammatory disease (PID).

METHODS: Patients with PID received an intramuscular injection of 250 mg of ceftriaxone, and were randomly assigned to receive 200 mg/d of doxycycline for 2 weeks, or 1 g of azithromycin per week, for 2 weeks. The degree of pain was assessed on days 2, 7, and 14 and clinical cure was assessed on day 14.

RESULTS: From 133 patients eligible for the study, 13 were excluded for having conditions other than PID, 11 were lost on follow-up, and three had oral intolerance to the antibiotics, yielding 106 for protocol analysis. No significant difference was observed regarding the degree of pain between the doxycycline and azithromycin groups. Clinical cure per protocol was 98.2% (56 of 57; 95% confidence interval [CI], 0.9–0.99) with azithromycin, and 85.7% (42 of 49; 95% CI, 0.72–0.93) with doxycycline (P=0.02). In a modified intention to treat analysis, clinical cure was 90.3% (56 of 62; 95% CI, 0.80–0.96) with azithromycin, and 72.4% (42 of 58; 95% CI, 0.58–0.82) with doxycycline (P=.01); a relative risk of 0.35, and a number needed to treat of six for benefit with azithromycin.

CONCLUSION: When combined with ceftriaxone, 1g of azithromycin weekly for 2 weeks is equivalent to ceftriaxone plus a 14-day course of doxycycline for treating mild PID.

CLINICAL TRIAL REGISTRATION: ISRCTN, http://isrctn.org, ISRCTN46117662

LEVEL OF EVIDENCE: I

This article has been cited by other articles:

				Ceftriaxone plus Azithromycin or Doxycycline for Pelvic Inflammatory Disease? Journal Watch Women's Health, September 6, 2007; 2007(906): 6 - 6. [Full Text]