Effectiveness of inpatient and outpatient treatment strategies for women with pelvic inflammatory disease: Results from the pelvic inflammatory disease evaluation and clinical health (peach) randomized trial

Roberta B. Ness, David E. Soper, Robert L. Holley, Jeffrey F. Peipert, Hugh Randall, Richard L. Sweet, Steven J. Sondheimer, Susan L. Hendrix, Antonio J. Amortegui, Giuliana Trucco, Thomas J. Songer, Judith R. Lave, Sharon L. Hillier, Debra C. Bass, Sheryl F. Kelsey
In: American Journal of Obstetrics and Gynecology · 2002 · vol. 186(5) , pp. 929–937 · doi:10.1067/mob.2002.121625 · PMID:12015517 · W2006370776
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This randomized trial compared the effectiveness of inpatient and outpatient treatment strategies for women diagnosed with pelvic inflammatory disease.

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Abstract

ObjectivePelvic inflammatory disease (PID) is a common and morbid intraperitoneal infection. Although most women with pelvic inflammatory disease are treated as outpatients, the effectiveness of this strategy remains unproven.Study designWe enrolled 831 women with clinical signs and symptoms of mild-to-moderate pelvic inflammatory disease into a multicenter randomized clinical trial of inpatient treatment initiated by intravenous cefoxitin and doxycycline versus outpatient treatment that consisted of a single intramuscular injection of cefoxitin and oral doxycycline. Long-term outcomes were pregnancy rate, time to pregnancy, recurrence of pelvic inflammatory disease, chronic pelvic pain, and ectopic pregnancy.ResultsShort-term clinical and microbiologic improvement were similar between women randomized to the inpatient and outpatient groups. After a mean follow-up period of 35 months, pregnancy rates were nearly equal (42.0% for outpatients and 41.7% for inpatients). There were also no statistically significant differences between outpatient and inpatient groups in the outcome of time to pregnancy or in the proportion of women with pelvic inflammatory disease recurrence, chronic pelvic pain, or ectopic pregnancy.ConclusionAmong women with mild-to-moderate pelvic inflammatory disease, there was no difference in reproductive outcomes between women randomized to inpatient treatment and those randomized to outpatient treatment.

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