Risks and Benefits of Presumptive Treatment for Pelvic Inflammatory Disease

Risks of untreated PID:

Chronic pelvic pain
Infertility (tubal damage-induced infertility)
- Twenty-five percent of females develop complications including tubal scarring and adhesions
Increased risk of ectopic pregnancy following PID (as much as 7- to 10-fold)
Increased risk of PID recurrence

Benefits of early treatment:

Treatment of PID addresses and provides:
- The relief of acute symptoms
- Eradicates current infection
- Minimizes the risk of long-term sequelae
Early diagnosis and treatment are critical in the preservation of fertility
Considering diagnostic difficulties and the potential for serious sequelae, the CDC advises that physicians maintain a low threshold to treat, with overtreatment preferred to no or delayed treatment

References:

Greydanus, E.E., Cabral, MD., & Patel, D.R. (2022). Pelvic inflammatory disease in the adolescent and young adult: An update. Disease-a-Month, 68, 101287. doi.org/10.1016/j.disamonth.2021.101287
Workowski, K. A., Bachmann, L. H., Chan, P. A., Johnston, C. M., Muzny, C. A., Park, I., Reno, H., Zenilman, J. M., & Bolan, G. A. (2021). Sexually Transmitted Infections Treatment Guidelines. MMWR Recomm Rep, 70(4), 1-187. https://doi.org/10.15585/mmwr.rr7004a1

These pathways do not establish a standard of care to be followed in every case. It is recognized that each case is different, and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare a pathway for each. Accordingly, these pathways should guide care with the understanding that departures from them may be required at times.

Risks and Benefits of Presumptive Treatment for Pelvic Inflammatory Disease

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