Patients with uncomplicated
pelvic inflammatory disease (PID) (acute
salpingitis and no pelvic masses) were randomly assigned for treatment with either
cefotaxime or
cefoxitin. A clinical cure was achieved in 17 of 20 cases (82%) and 19 of 22 cases (84%), respectively. Within the complicated PID group, patients were assigned to two subgroups: those with a tubo-ovarian complex (26 patients), and those with a tubo-ovarian
abscess (32 patients), as confirmed by ultrasonography or surgery. Patients within each of these two subgroups were then randomly assigned for treatment with either
cefotaxime or
clindamycin plus
gentamicin. Within the tubo-ovarian complex subgroup, a clinical cure was achieved in 11 of 13 cases (85%) treated with
cefotaxime and 10 of 13 cases (77%) treated with
clindamycin plus
gentamicin. Within the tubo-ovarian
abscess subgroup, a clinical cure was achieved in 12 of 16 cases (75%) treated with
cefotaxime and 11 of 16 cases (69%) treated with
clindamycin plus
gentamicin. No differences in any category were statistically significant. Specimens for culture were obtained from the endocervix, endometrium, and when possible, the cul-de-sac, fallopian tubes, and
abscess. Neisseria gonorrhoeae (33%) was isolated more frequently than Chlamydia trachomatis (12%) in patients with PID, and neither of these organisms was isolated with any increased frequency in patients with complicated PID. The majority of the patients were considered to have
polymicrobial infection.
Cefotaxime was as efficacious as
cefoxitin and
clindamycin plus
gentamicin for the treatment of acute
salpingitis, tubo-ovarian complex and tubo-ovarian
abscess.