State-of-the-art therapy for salpingo-oophoritis from the perspective of novel clinical guidelines
DOI: 10.32364/2618-8430-2022-5-1-35-40
M.S. Selikhova, A.A. Smol’yaninov
Volgograd State Medical University, Volgograd, Russian Federation
Abstract
Pelvic inflammatory disease (PID) is an important issue due to its high occurrence in women of reproductive age and adverse effects on reproductive function. In 2021, the Ministry of Health of the Russian Federation had approved clinical guidelines that standardized management and treatment approaches to PID. These novel clinical guidelines focus on rational outpatient antimicrobial therapy using broad-spectrum medications. Treatment is prescribed empirically considering the predominant polymicrobial nature of PID. Opportunistic microbes (i.e., obligatory and facultative anaerobes) increasingly become causative agents of PID. Low titers of these microbes are found in the normal vaginal microflora, favoring broad-spectrum antibiotics effective against gram-positive and gram-negative bacteria. Treatment duration should be at least 10–14 days to completely eradicate the pathogen and prevent chronicity. Attention should be focused on choosing antibiotics with favorable safety p rofiles.
Keywords: pelvic inflammatory disease, clinical guidelines, outpatient treatment, antibiotics, doxycycline, dispersible tablet, adherence.
For citation: Selikhova M.S., Smol’yaninov A.A. State-of-the-art therapy for salpingo-oophoritis from the perspective of novel clinical guidelines. Russian Journal of Woman and Child Health. 2022;5(1):35–40 (in Russ.). DOI: 10.32364/2618-8430-2022-5-1-35-40.
Acknowledgements
The technical edition is supported by the State Corporation "Farmstandart".
About the authors:
Marina S. Selikhova — Dr. Sc. (Med.), Professor, professor of the Department of Obstetrics and Gynecology, Volgograd State Medical University; 1, Pavshikh Bortsov sq., Volgograd, 400131, Russian Federation; ORCID iD 0000-0002-4393-6111.
Aleksandr A. Smol’yaninov — postgraduate student of the Department of Obstetrics and Gynecology, Volgograd State Medical University; 1, Pavshikh Bortsov sq., Volgograd, 400131, Russian Federation; ORCID iD 0000-0002-4113-0771.
Contact information: Marina S. Selikhova, e-mail: selichovamarina@yandex.ru.
Financial Disclosure: no authors have a financial or property interest in any material or method mentioned.
There is no conflict of interests.
Received 29.11.2021.
Revised 22.12.2021.
Accepted 14.01.2022.
2. Workowski K.A., Bolan G.A., Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep. 2015;64(RR-03):1–137.
3. The British Association for Sexual Health and HIV (BASHH). United Kingdom National Guideline for the Management of Pelvic Inflammatory Disease (2019 Interim Update).
4. Ross J., Guaschino S., Cusini M., Jensen J. 2017 European guideline for the management of pelvic inflammatory disease. Int J STD AIDS. 2018;29(2):108–114. DOI: 10.1177/0956462417744099.
5. Gynecology: a national guide. Savelieva G.M., Sukhikh G.T., Serov V.N. et al., eds. M.: GEOTAR-Media; 2017 (in Russ.).
6. Selikhova M.S., Soltys P.A. Modern accents in the diagnosis of inflammatory diseases of the pelvic organs. Arkhiv akusherstva i ginekologii im. V.F. Snegireva. 2020;7(1):37–42 (in Russ.). DOI: 10.18821/2313-8726-2020-7-1-37-42.
7. Canadian Guidelines on Sexually Transmitted Infections. Management and treatment of specific syndromes — Pelvic Inflammatory Disease. (Electronic resource.) URL: https://www.canada.ca/en/public-health/services/infectious-diseases/sexual-health-sexually-transmitted-infections/canadian-guidelines/sti-associated-syndromes/pelvic-inflammatory-disease.html (access datе: 17.12.2021).
8. Erenel H., Yilmaz N., Oncul M. et al. Usefulness of Serum Procalcitonin Levels in Predicting Tubo-Ovarian Abscess in Patients with Acute Pelvic Inflammatory Disease. Gynecol Obstet Invest. 2017;82(3):262–266. DOI: 10.1159/000449161.
9. De Carvalho N.S., Palú G., Witkin S.S. Mycoplasma genitalium, a stealth female reproductive tract. Eur J Clin Microbiol Infect Dis. 2020;39(2):229–234. DOI: 10.1007/s10096-019-03707-8.
10. Lis R., Rowhani-Rahbar A., Manhart L.E. Mycoplasma genitalium infection and female reproductive tract disease: a meta-analysis. Clin Infect Dis. 2015;61(3):418–426. DOI: 10.1093/cid/civ312.
11. Miller J.M., Binnicker M.J., Campbell S. et al. A Guide to Utilization of the Microbiology Laboratory for Diagnosis of Infectious Diseases: 2018 Update by the Infectious Diseases Society of America and the American Society for Microbiology. Clin Infect Dis. 2018;67(6):e1–e94. DOI: 10.1093/cid/ciy381.
12. Savaris R.F., Fuhrich D.G., Duarte R.V. et al. Antibiotic therapy for pelvic inflammatory disease: an abridged version of a Cochrane systematic review and metaanalysis of randomised controlled trials. Sex Transm Infect. 2019;95(1):21–27. DOI: 10.1136/sextrans-2018-053693.
13. Sartelli M., Weber D.G., Ruppé E. et al. Antimicrobials: a global alliance for optimizing their rational use in intra-abdominal infections (AGORA). World J Emerg Surg. 2016;11:33. DOI: 10.1186/s13017-016-0089-y.
14. Price M.J., Ades A.E., De Angelis D. et al. Risk of pelvic inflammatory disease following Chlamydia trachomatis infection: analysis of prospective studies with a multistate model. Am J Epidemiol. 2013;178(3):484–492. DOI: 10.1093/aje/kws583.
15. Selikhova M.S, Soltys P.A., Smolyaninov A.A. Treatment and prevention of recurrent vulvovaginal infections in patients with pelvic inflammatory disease. Gynecology, Obstetrics and Perinatology. 2021;20(2):58–65 (in Russ.). DOI: 10.20953/1726-1678-2021-2-58-64.
16. Dhasmana D., Hathorn E., McGrath R. et al. The effectiveness of nonsteroidal anti-inflammatory agents in the treatment of pelvic inflammatory disease: a systematic review. 2014;3:79. DOI: 10.1186/2046-4053-3-79.
17. Scholten R.J., Koes B.W., Deyo R.A., van Tulder M.W. Non-steroidal anti-inflammatory drugs for low back pain. Cochrane Database Syst Rev. 2000;(2):CD000396. DOI: 10.1002/14651858.CD000396.
18. Savaris R.F., Fuhrich D.G., Duarte R.V. et al. Antibiotic therapy for pelvic inflammatory disease: an abridged version of a Cochrane systematic review and meta-analysis of randomised controlled trials. Sex Transm Infect. 2019;95(1):21–27. DOI: 10.1136/sextrans-2018-053693.
19. Deriushkin V.G., Ternavskii A.P., Gatsura S.V. Pharmacoeconomic analysis of first-choice antimicrobials drugs prescribed for outpatient treatment of non-severe community-acquired pneumonia. FARMAKOEKONOMIKA. Modern Pharmacoeconomics and Pharmacoepidemiology. 2020;13(4):329–336 (in Russ.). DOI: 10.17749/2070-4909/farmakoekonomika.2020.048.
20. Belousov Yu.B., Danilov A.N., Zyryanov S.K., Rachina S.A. Doxycycline-associated drug-induced esophagitis: modern pharmacological possibilities for solving a clinical problem. Consilium medicum. 2012;4:57–63 (in Russ.).
21. Doxycycline EXPRESS. Instructions for the medical use of the medicinal product. (Electronic resource.) URL: https://grls.rosminzdrav.ru/Grls_View_v2.aspx?routingGuid=0cd43919–0b28–42ba-9dcb-214e5e691ed0&t= (access date: 17.11.2021) (in Russ.).
22. Yakovlev S.V., Dovgan’ Ye.V. Aspects of the effectiveness of antibiotics. Spravochnik poliklinicheskogo vracha. 2014;6:4–5 (in Russ.).
23. Zyryanov S.K., Baibulatova E.A. The use of new dosage forms of antibiotics as a way to improve the efficiency and safety of antibiotic therapy. Antibiotics and Chemotherapy. 2019;64(3–4):81–91 (in Russ.).
This work is licensed under a Creative Commons «Attribution» 4.0 License.
Распечатать