Abstract
OBJECTIVE: To evaluate the safety and efficacy of intravenous and oral ofloxacin monotherapy in the treatment of laparoscopically documented acute pelvic inflammatory disease (PID). METHODS: This study was conducted as an open-label, phase-III, uncontrolled, multicenter study. Patients identified with laparoscopic findings of salpingitis were treated with 400 mg of intravenous ofloxacin every 12 hours followed by 400 mg of oral ofloxacin every 12 hours for 10 to 14 days. Patients were evaluated five times for clinical and microbial efficacy. Since laparoscopy was performed only at admission, pathogens identified laparoscopically were presumed eradicated if they were present on the laparoscopic culture and the patient was clinically cured or improved at final evaluation. RESULTS: Of the 70 patients evaluable for safety (intent-to-treat population), the mean age was 25.6 years. Sixty-one of 70 patients (87%) were cured, one improved, one did not improve, and seven were unevaluable because they discontinued study participation. Fifty-one were evaluable for clinical efficacy: 50 (98%) were cured and one did not improve. Sixteen were evaluable for expanded microbiological efficacy: three had documented Neisseria gonorrhoeae; 12, Chlamydia trachomatis; and one, a mixed infection of both organisms. All cervical, laparoscopic, and endometrial cultured pathogens, including N. gonorrhoeae and C. trachomatis, were eradicated or presumed eradicated at the posttherapy visit. No serious or unexpected adverse events occurred. CONCLUSIONS: Ofloxacin monotherapy was effective and well tolerated in the treatment of laparoscopically proven PID in a geographically diverse population. Future studies are necessary to evaluate long-term outcomes and sequelae of PID treatment with single agent therapy.
Full Text
The Full Text of this article is available as a PDF (649.0 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Eschenbach D. A., Buchanan T. M., Pollock H. M., Forsyth P. S., Alexander E. R., Lin J. S., Wang S. P., Wentworth B. B., MacCormack W. M., Holmes K. K. Polymicrobial etiology of acute pelvic inflammatory disease. N Engl J Med. 1975 Jul 24;293(4):166–171. doi: 10.1056/NEJM197507242930403. [DOI] [PubMed] [Google Scholar]
- Jossens M. O., Schachter J., Sweet R. L. Risk factors associated with pelvic inflammatory disease of differing microbial etiologies. Obstet Gynecol. 1994 Jun;83(6):989–997. doi: 10.1097/00006250-199406000-00019. [DOI] [PubMed] [Google Scholar]
- Martens M. G., Gordon S., Yarborough D. R., Faro S., Binder D., Berkeley A. Multicenter randomized trial of ofloxacin versus cefoxitin and doxycycline in outpatient treatment of pelvic inflammatory disease. Ambulatory PID Research Group. South Med J. 1993 Jun;86(6):604–610. doi: 10.1097/00007611-199306000-00002. [DOI] [PubMed] [Google Scholar]
- McCormack W. M., Nowroozi K., Alpert S., Sackel S. G., Lee Y. H., Lowe E. W., Rankin J. S. Acute pelvic inflammatory disease: characteristics of patients with gonococcal and nongonococcal infection and evaluation of their response to treatment with aqueous procaine penicillin G and spectinomycin hydrochloride. Sex Transm Dis. 1977 Oct-Dec;4(4):125–131. [PubMed] [Google Scholar]
- Monk J. P., Campoli-Richards D. M. Ofloxacin. A review of its antibacterial activity, pharmacokinetic properties and therapeutic use. Drugs. 1987 Apr;33(4):346–391. doi: 10.2165/00003495-198733040-00003. [DOI] [PubMed] [Google Scholar]
- Schachter J., Stoner E., Moncada J. Screening for chlamydial infections in women attending family planning clinics. West J Med. 1983 Mar;138(3):375–379. [PMC free article] [PubMed] [Google Scholar]
- Soper D. E., Brockwell N. J., Dalton H. P. Microbial etiology of urban emergency department acute salpingitis: treatment with ofloxacin. Am J Obstet Gynecol. 1992 Sep;167(3):653–660. doi: 10.1016/s0002-9378(11)91566-x. [DOI] [PubMed] [Google Scholar]
- Sweet R. L., Schachter J., Robbie M. O. Failure of beta-lactam antibiotics to eradicate Chlamydia trachomatis in the endometrium despite apparent clinical cure of acute salpingitis. JAMA. 1983 Nov 18;250(19):2641–2645. [PubMed] [Google Scholar]
- Toomey K. E., Rafferty M. P., Stamm W. E. Unrecognized high prevalence of Chlamydia trachomatis cervical infection in an isolated Alaskan Eskimo population. JAMA. 1987 Jul 3;258(1):53–56. [PubMed] [Google Scholar]
- Wendel G. D., Jr, Cox S. M., Bawdon R. E., Theriot S. K., Heard M. C., Nobles B. J. A randomized trial of ofloxacin versus cefoxitin and doxycycline in the outpatient treatment of acute salpingitis. Am J Obstet Gynecol. 1991 May;164(5 Pt 2):1390–1396. doi: 10.1016/0002-9378(91)91479-g. [DOI] [PubMed] [Google Scholar]