Anaerobes in Pelvic Inflammatory Disease: Implications for the Centers for Disease Control and Prevention's Guidelines for Treatment of Sexually Transmitted Diseases

• Published in: Clinical infectious diseases Vol. 28; no. Supplement-1; pp. S29 - S36
• Main Authors: Walker, Cheryl K., Workowski, Kimberly A., Washington, A. Eugene, Soper, David, Sweet, Richard L.
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Chicago, IL The University of Chicago Press 01-01-1999; University of Chicago Press
• Subjects: Anaerobic bacteria; Antibiotics; Antimicrobials; Bacteria, Anaerobic; Bacterial diseases; Bacterial diseases of the genital system; Bacterial vaginosis; Biological and medical sciences; Centers for Disease Control and Prevention (U.S.); Female; Genitalia; Human bacterial diseases; Humans; Infections; Infectious diseases; Medical sciences; Pathogenesis; Pelvic inflammatory disease; Pelvic Inflammatory Disease - drug therapy; Pelvic Inflammatory Disease - microbiology; Practice Guidelines as Topic; Salpingitis; Sexually transmitted diseases; Sexually Transmitted Diseases - drug therapy; Sexually Transmitted Diseases - microbiology; United States; United States; Human; Pathogenesis; Acute; Recommendation; Female genital diseases; Prevention; Chemotherapy; Chronic; Microbiological investigation; Treatment; Anaerobe; Etiology; Bacteria; Female; Salpingitis; Antibacterial agent; Fallopian tube pathology
• ISSN: 1058-4838; 1537-6591
• DOI: 10.1086/514720

In preparing the 1998 sexually transmitted disease treatment guidelines of the Centers for Disease Control and Prevention, we reviewed evidence regarding the need to eradicate anaerobes when treating pelvic inflammator disease (PID). Anaerobes are present in the upper genital tract during an episode of acute PID, with the prevalence dependent on the population under study. Vaginal anaerobes can facilitate acquisition of PID and cause tissue damage to the fallopian tube, either directly or indirectly through the host inflammator response. Use of several broad-spectrum regimens appears to result in excellent clinical cure rates, despite the fact that some combinations fall short of providing comprehensive coverage of anaerobes. There are limited data on the long-term effects of failing to eradicate anaerobes from the upper genital tract. Concern that tissue damage may continue when anaerobes are suboptimally treated has prompted many experts to caution that therapeutic regimens should include comprehensive anaerobic coverage for optimal treatment of women with PID.