Pelvic Inflammatory Disease Pregnancy

Most likely pathogens

Duration of Therapy

Parenteral therapy may be discontinued 24 hours after patient improves clinically, and oral therapy with either [erythromycin (base) 250 mg PO q6h]
OR [clindamycin 450 mg PO q6h]

+/- metronidazole 500 mg PO q12h] should continue for a total of 14 days

Suggested Regimen

Cefoxitin 2 g IV q6h

AND

Erythromycin
250 mg PO q6h x 14d
(In the event that erythromycin is not tolerated, limited data suggest that azithromycin 1 g PO in a single dose then 1 g PO in a single dose in 1 week (for a total of 2 doses given 7 days apart) may also be effective.

OR

Ceftriaxone 1 g IV q24h

AND

Metronidazole 500 mg IV/PO q12h

AND

Erythromycin
250 mg PO q6h x 14d
(In the event that erythromycin is not tolerated, limited data suggest that azithromycin 1 g PO in a single dose then 1 g PO in a single dose in 1 week (for a total of 2 doses given 7 days apart) may also be effective.

OR

Clindamycin 900 mg IV q8h

AND

Gentamicin

5 mg/kg/dose IV q24h
Maximum: 500 mg/24 h prior to levels

Penicillin allergy

Clindamycin 900 mg IV q8h

AND

Gentamicin 5 mg/kg/dose IV q24h
Maximum: 500 mg/24 h prior to levels