The objective of the study was to compare the efficacy of azithromycin, alone or with metronidazole, versus two standard multidrug regimens for the treatment of acute pelvic inflammatory disease (PID). Patients with PID were treated with once-daily intravenous (i.v.) azithromycin 500 mg for 1 day or 2 days followed by once-daily azithromycin 250 mg orally for a total of 7 days, alone or with three-times-daily metronidazole 400 mg or 500 mg i.v. then orally for a total of 12-14 days. The comparators were either metronidazole + doxycycline + cefoxitin + probenecid or doxycycline + amoxycillin/clavulanate given at standard recommended doses for up to 21 days. In total, 309 patients were treated for PID. The diagnosis was confirmed laparoscopically in 74.8% of patients. Rates of clinical success for azithromycin, alone (97.1%) or with metronidazole (98.1%), were comparable to those for the comparator regimens (94.6%). Eradication rates for Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma hominis and anaerobes were also comparable for each of the treatment groups. Both azithromycin regimens were well tolerated. In conclusion, azithromycin, alone or with metronidazole, provides a shorter, simpler treatment option for the successful management of acute PID.

Poster presentations Objectives Highly sensitive and specific assays for diagnosis of Neisseria gonorrhoeae (NG) are imperative. Unfortunately, several commercial and in house NG nucleic acid amplification tests (NAATs) have shown suboptimal specificity. The Neisseria gonorrhoeae PCR kit (GeneProof) is a novel NG dual-target (porA pseudogene and 16S rRNA gene) real-time PCR. Herein, the analytical sensitivity and specificity of the NG PCR kit (GeneProof) were evaluated using a collection of well-characterised gonococcal isolates (n = 105), with a global representativeness, and non-gonococcal Neisseria isolates (n = 149; 21 different species and subspecies), as well as specimens positive with three other commercially available NAATs (n = 37). Methods DNA was extracted from all samples using the NorDiag Bullet robot (NorDiag ASA Company) and kept in-20°C prior to testing. All samples were tested on LightCycler 2.0 (Roche Molecular Systems Inc.) by adding 10 µl of DNA to 30 µl NG PCR kit (GeneProof) reagent mix. Results All 105 gonococcal isolates, including three porA mutants, were detected and none of the 149 non-gonococcal Neisseria strains were false positive. Accordingly, the assay displayed 100% analytical sensitivity and specificity. The analytical sensitivity was 1-10 genome copies per reaction. All positive samples from the Abbott RealTime PCR CT/NG (Abbott Laboratories) (n = 5) and COBAS 4800 (Roche Molecular Systems Inc.) systems (n = 8) were verified. However, for the BD ProbeTec ET/Qx Chlamydia trachomatis and Neisseria gonorrhoeae Amplified DNA (Becton Dickinson) only eight out of 24 low-positive samples could be verified as true positive. Conclusions This study shows that the GeneProof NG PCR kit is analytically highly specific and sensitive for detection of N. gonorrhoeae. This study also emphasises the importance of verifying N. gonorrhoeae NAAT positive specimens, particularly specimens that are low positive or from extragenital sites, with an alternative NAAT using a different target.