Reports From the Field: Outpatient treatment for PID as effective as inpatient treatment
Women with mild-to-moderate pelvic inflammatory disease (PID) who are treated as outpatients have recovery and reproductive outcomes similar to those for women treated in hospitals, the Agency for Healthcare Research and Quality (AHRQ)1 has concluded.
The PID Evaluation and Clinical Health study was a randomized clinical trial to compare the effectiveness of outpatient and inpatient strategies in preserving fertility and preventing PID recurrence, chronic pain, and ectopic pregnancy. Women treated in a hospital were given multiple intravenous doses of cefoxitin and doxcycline during an inpatient stay of 48 hours or longer. Those who were treated as outpatients received a single injection of cefoxitin, an oral dose of probenecid, and a 14-day supply of oral doxycycline.
The short-term clinical improvements were similar for women in both groups, and after 35 months, the pregnancy rates were nearly equal. There was no statistical significance between the proportion of women with ectopic pregnancy, chronic pelvic pain, or PID recurrence.
"Treating women with PID in an outpatient setting means receiving care won’t disrupt their daily lives and those of their families. This study provides the first evidence of the comparable effectiveness of outpatient treatment," says Carolyn Clancy, MD, acting director of AHRQ.
1. Ness R et al Effectiveness of inpatient and outpatient treatment strategies for women with pelvic inflammatory disease: Results from the PID Evaluation and Clinical Health (PEACH) Randomized Trial. Am J Obstet Gynecol 2002: 186; 929-37.