Conservative management of PID.

The goals in the management of pelvic inflammatory disease (PID) are not only treatment of the infection and prevention of immediate complications, but also prevention of its long-term consequences. There are criteria for hospitalization, but patients who do not meet them can be safely treated as outpatients. A variety of sexually transmitted and other microorganisms can cause this infection, but the most important are Chlamydia trachomatis and Neisseria gonorrhoeae. Regimens with activity against gonococci, chlamydiae, streptococci, gram-negative bacteria, and anaerobes should be administered. Several such antimicrobial regimens have shown very good clinical and microbiologic efficacy. However, their efficacy in preventing long-term complications, such as infertility, has not been established. Close follow-up is an important part of management. Evaluation of male sexual partners is imperative to prevent reinfection. Better diagnostic techniques and treatment modalities for PID must be developed to prevent its long-term consequences.