武功密笈

小黃藏書

1. Pathogen:

w Most commonly: sexually transmitted microorganisms

such as Neisseria gonorrhoeae, Chlamydial trachomatis

w Less frequently:

Haemophilus influenzae, Group A streptococci, pneumococci,

endogenous microorganisms (BV microortanisms), etc.

　

2. Diagnosis: (Clinical Criteria)

Symptoms:

None necessary

Signs:

Pelvic organ tenderness

Leukorrhea and/or mucopurulent endocervicitis

Additional criteria to increase the specificity of the diagnosis:

Endometrial biopsy showing endometritis

Elevated CRP or ESR

Temperature higher than 38^oC

Leukocytosis

Positive test for gonorrhea or chlamydia

Elaborate criteria:

Sonography documenting tubo-ovarian abscess

Laparoscopy visually confirming salpingitis

　

3. Treatment:

w CDC Guidelines for Treatment of PID: (劑量與本院藥典用法不盡相同!)

Outpatient Treatment:

Regimen A:

? Mefoxin (1) 2g im + probenecid 1g po,

或Rocephin (500) 250mg im

‚ Doxycylcine (100) 100mg po bid for 14 days

Regimen B:

? Tarivid (100) 400mg po bid for 14 days

‚ Cleocin (150) 450 mg po qid for 14 days

Inpatient Treatment:

Regimen A:

? Mefoxin (1) 2g iv q6h, 或Cefotetan (?) 2g iv q6h

‚ Doxycycline (100) 100mg iv/po q12h

Regimen B:

? Cleocin (300) 900mg iv q8h

‚ Gentamicin loading dose iv/im (2mg/kg) followed by

a maintenance dose (1.5mg/kg) q8h

w Treatment Regiments for Gonococcal and Chlamydial Infections:

Rocephin (500) 125mg im, 或

Tarivid (100) 400mg po, 或 皆為

Cefixime (100) 400mg po, 或 single dose

Doxycycline (100) 100mg po bid for 7 days, 或

Tarivid (100) 300mg po bid for 7 days, 或

Erythromycin ethylsuccinate 800mg po qid for 7 days, 或

Erythromycin base 500 mg po qid for 7 days 或 ?