Pelvic Abscess | Spectrum

Most Likely Pathogens

Polymicrobial genital tract organisms including aerobes and anaerobes

Duration of Therapy

Continue parenteral therapy

until patient is afebrile for 48 hours and convert to oral therapy with amoxicillin-clavulanate 500 mg PO q8h OR [levofloxacin 500-750 mg PO q24h AND metronidazole 500 mg PO q12h] to continue for a total of 14 days if clinical improvement.

Note

Drainage (image guided or laparoscopic) may be required, if no response to antimicrobial therapy after 48-72 hours and if abscess > 8 cm

Suggested Regimen

Ceftriaxone 1 g IV q24h

AND

Metronidazole 500 mg IV/PO q12h

Oral Therapy

Amoxicillin-Clavulanate 500 mg PO q8h

OR

Levofloxacin 500-750 mg PO once daily

AND

Metronidazole 500 mg PO q12h

Penicillin Allergy

Ceftriaxone 1 g IV q24h

AND

Metronidazole 500 mg IV/PO q12h