Do short-term markers of treatment efficacy predict long-term sequelae of pelvic inflammatory disease?

Abstract

OBJECTIVE:

This study was undertaken to assess whether short-term markers, often used to measure clinical cure after treatment for pelvic inflammatory disease, predict sequelae of lack of pregnancy, recurrent pelvic inflammatory disease, and chronic pelvic pain.

STUDY DESIGN:

Women with mild-to-moderate pelvic inflammatory disease were assessed after treatment initiation at 5 days for tenderness (n = 713) and at 30 days for tenderness, cervical infections and endometritis (n = 298). Pregnancy, recurrent pelvic inflammatory disease, and chronic pelvic pain were evaluated after 84 months, on average.

RESULTS:

Pelvic tenderness at 5 and at 30 days significantly elevated the risk for developing chronic pelvic pain; tenderness at 30 days was also significantly associated with recurrent pelvic inflammatory disease. However, pelvic tenderness at 5 and at 30 days was only modestly clinically predictive of chronic pelvic pain or recurrent pelvic inflammatory disease (positive predictive values 22.1-66.9%). No short-term marker significantly influenced the likelihood of achieving a pregnancy.

CONCLUSION:

Tenderness at 5 or 30 days did not accurately predict the occurrence of pelvic inflammatory disease-related reproductive morbidities.

• Authors: Gail M Trautmann, Kevin E Kip, Holly E Richter, David E Soper, Jeffrey F Peipert, Deborah B Nelson, Wayne Trout, Dianne Schubeck, Debra C Bass, Roberta B Ness
• Journal: American journal of obstetrics and gynecology (Am J Obstet Gynecol) Vol. 198 Issue 1 Pg. 30.e1-7 (Jan 2008) ISSN: 1097-6868 [Electronic] United States
• PMID: 18166300 (Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, N.I.H., Extramural, Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Inflammation Mediators
• Cefoxitin
• Doxycycline
• Probenecid

Topics

• Administration, Oral
• Adolescent
• Adult
• Cefoxitin (administration & dosage)
• Dose-Response Relationship, Drug
• Doxycycline (administration & dosage)
• Drug Administration Schedule
• Drug Therapy, Combination
• Female
• Follow-Up Studies
• Humans
• Infertility, Female
• Inflammation Mediators (analysis)
• Infusions, Intravenous
• Pain Measurement
• Pelvic Inflammatory Disease (diagnosis, drug therapy)
• Predictive Value of Tests
• Probability
• Probenecid (administration & dosage)
• Proportional Hazards Models
• Recurrence
• Severity of Illness Index
• Time Factors
• Treatment Outcome