Pelvic inflammatory disease.

Two studies compared and showed equal efficacy of the two intravenous treatment regimens recommended by the Centers for Disease Control: cefoxitin plus doxycycline and aminoglycoside plus clindamycin. The increased risk of pelvic inflammatory disease (PID) among users of an intrauterine device was confirmed in a reanalysis of the Oxford Family Planning Study. However, a prospective study showed that prophylactic, single-dose oral doxycycline significantly reduced the risk of post-insertion gonococcal, but not chlamydial, PID. According to Canadian investigators, laparoscopy is not very specific for PID diagnosis when tubal and endometrial histopathology is used as the gold standard. Two studies showed that vaginal douching is significantly associated with PID and with ectopic pregnancy. The risk of PID increased with frequency of douching. Data from the Women's Health Study suggest increased risk of PID among cigarette smokers. However, the risk of PID was unrelated to the number of cigarettes smoked.