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Bacterial STIs
P63 Treatment of pelvic inflammatory disease using short-course azithromycin
  1. L Cunningham1,
  2. A Murray1,
  3. P J Horner2
  1. 1University Hospitals Bristol NHS Foundation Trust, Bristol, UK
  2. 2University Hospitals Bristol NHS Foundation Trust/University of Bristol, Bristol, UK

Abstract

Background In our centre, a novel 5-day regimen of azithromycin (1 g stat then 500 mg daily for 4 days with or without metronidazole and/or ceftriaxone) is used and has been approved regionally. This is administered as an alternative regimen in selected cases of pelvic inflammatory disease (PID), usually those with milder symptoms and signs.

Aims and Objectives We assessed the use and efficacy of short course azithromycin in PID. We also assessed follow-up rates and adherence for all cases of PID.

Methods Retrospective case note review of 129 female patients coded as PID during the period 1 July to 31 December 2011. Data were collected and transferred to Excel for analysis.

Results 109/129 (84.5%) of women were diagnosed with PID based on symptoms and signs as described in the BASHH PID guideline. Chlamydia was subsequently diagnosed in 10/108 (9.3%) and gonorrhoea in 5/108 (4.6%). Chlamydia antibody titres of >1 in 256 were found in 20/65 (30.8%) of patients. Taking into account missing data, 39/51 (76.5%) patients completed the antibiotic course and 64/78 (82%) reported full or partial resolution of symptoms. 14/85 (16.5%) required further PID treatment, eight of whom had sexual intercourse with an untreated partner (see abstract P63 table 1).

Abstract P63 Table 1

Antibiotic regime for PID treatment and response

Discussion In this study, 32/109 (29.4%) women were treated for PID with azithromycin either in combination or alone. Overall, the majority of women completed treatment and reported a full or partial improvement in symptoms. Follow-up rates were good but documentation was inadequate. Comparisons between regimens are limited due to missing data. Further work will look at novel follow-up methods such as routine telephone contact as well as standardisation of follow-up documentation.

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