BASHH | Pelvic inflammatory disease

Little of this new guideline is new. Take home messages for me were:

  • Only 25% cases are caused by gonorrhoea/chlamydia. The rest are other STDs and non STDs.
  • Any young, sexually active female (ie <25 yrs) should have PID considered and empiric treatment offered if they present with recent onset bilateral lower abdominal pain and local tenderness on VE, if pregnancy has been excluded.
  • Partners should be offered empirical treatment with 1g azithromycin stat (as many infections don’t show up on swabs).
  • Refer to local guidelines for best antibiotic treatment, but if gonorrhoea is possible, 250mg im ceftriaxone should be given stat.
  • If early pregnancy is possible, but there is a negative pregnancy test, the normal regimes are OK (ie it is better to treat and risk to the fetus is low).
  • Follow-up all patients, partly to check they are responding, but also to reiterate safe-sex advice / partner follow-up etc.
  • This guidance will include a patient information leaflet, but it’s not out yet.

Louise Hudman

I'm a freelance GP locum in Winchester & Southampton locum chambers, and Pallant Medical Chambers Clinical Guidelines Lead Partner.

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