Comparison of CT‐ or ultrasound‐guided drainage with concomitant intravenous antibiotics vs. intravenous antibiotics alone in the management of tubo‐ovarian abscesses

Goharkhay, Nima; Verma, Usha; Maggiorotto, Furio

doi:10.1002/uog.3890

Cited by 73 publications

(86 citation statements)

References 20 publications

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“…Traditional treatment for TOA and pelvic abscess is the use of broad-spectrum antibiotics [7] and is effective in about 34-88% of the cases [8,9] but lower for large abscesses [10]. Surgical intervention is necessary if there is no clinical response at ≥72 h of antibiotic treatment or ruptured abscess.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness and Adverse Events of Early Laparoscopic Therapy versus Conservative Treatment for Tubo-Ovarian or Pelvic Abscess: A Single-Center Retrospective Cohort Study

Chu

Liang

et al. 2019

Gynecol Obstet Invest

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Background/Aim: We aimed to assess the value of early laparoscopic therapy in management of tubo-ovarian abscess (TOA) or pelvic abscess. Methods: This was a retrospective study of all consecutive patients who were initially diagnosed with TOA or pelvic abscess at the local hospital between January 2010 and December 2014. The risks of operation and recurrence were analyzed using logistic analyses. Results: The durations of body temperature > 38.0°C (p = 0.001) and hospitalization (p < 0.001) were longer in the conventional group versus the early laparoscopy group. In the conventional group, 15 (50%) patients finally underwent laparoscopic exploration. The abscess size in the late laparoscopic group was significantly larger than the successful antibiotic treatment group (6.3 ± 1.5 vs. 4.9 ± 1.2 cm, p = 0.010). Abscess > 5.5 cm was independently associated with antibiotic failure (OR 4.571; 95% CI 1.612–12.962). Compared with late laparoscopy, early laparoscopy was associated with a shorter operation time (p = 0.037), less blood loss (p = 0.035), and shorter durations of body temperature > 38.0°C (p < 0.001) and hospitalization (p < 0.001). The cost was the lowest in the patients successfully treated conservatively. Conclusion: Early laparoscopic treatment is associated with shorter time of fever resolution, shorter hospitalization, and less blood loss compared with conventional treatment for TOA or pelvic abscess.

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Section: Introductionmentioning

confidence: 99%

Effectiveness and Adverse Events of Early Laparoscopic Therapy versus Conservative Treatment for Tubo-Ovarian or Pelvic Abscess: A Single-Center Retrospective Cohort Study

Chu

Liang

et al. 2019

Gynecol Obstet Invest

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“…However, it has been shown that surgical management via ultrasound guided drainage is a safe and efficacious alternative compared to IV antibiotics alone. In one study, patients treated primarily with ultrasound guided drainage had short hospital stays and faster resolution of symptoms [9]. Cost of care may be another reason that optimal treatment is being delayed.…”

Section: Discussionmentioning

confidence: 99%

“…35% of abscesses measuring 7-9 cm and 60% measuring ≥10 cm ultimately require surgical management; abscesses >8 cm more often require drainage or surgery and are associated with longer hospitalization [5,8]. Moreover, ultrasound guided drainage of TOA with concomitant use of intravenous antibiotics is a safe and effective alternative; compared to IV antibiotics alone, ultrasound guided drainage may lead to shorter hospitalizations and more rapid resolution of symptoms [9].…”

Section: Introductionmentioning

confidence: 99%

Surgical, Ultrasound Guided Drainage, and Medical Management of Tuboovarian Abscesses

Crespo

Ganesh

et al. 2014

ISRN Infectious Diseases

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Objective. To compare surgical, ultrasound guided drainage, and medical management of tuboovarian abscesses (TOA) and determine if different characteristics in patient presentation influence treatment and outcome. Methods. Retrospective cohort study of 158 patients admitted to Jackson Memorial Hospital between 2007 and 2012 with a TOA. Results. Patients treated with IV antibiotics (IV) alone were hospitalized for 5.59 days (SD 2.52), IV antibiotics and US guided drainage (IV/US) were hospitalized for 9.63 days (SD 7.58), and IV antibiotics and surgery (IV/surgery) were hospitalized for 8.14 days ((SD 3.9), ( < 0.001)). A total of 52 patients were readmitted with TOA; 41.8% were treated with IV; 26.9% were readmitted with IV/US; 7.1% were readmitted with IV/surgery ( < 0.022). Patients with a TOA measuring 0-8 cm were hospitalized for 5.97 days (SD 4.24), while those greater than 8 cm were hospitalized for 7.71 days ((SD 4.69), ( < 0.029)). Patients treated with a triple antibiotic regimen were hospitalized for 8.42 days (SD 5.70) versus 5.8 days (SD 3.24) when receiving an alternative regimen ( < 0.002). Conclusions. Longer hospitalization in patients treated uniformly with either triple antibiotics, ultrasound guided drainage, or surgery represents a delay in optimal treatment. Tailoring treatment plans based on patient presentation may allow for shorter hospital stays and improved morbidity.

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“…According to data, medical treatment alone with broad-spectrum antibiotics is successful between 34 and 87,5% of all cases 3 , and the let of response to conservative therapy can be due to insufficient penetration of antibiotics into the abscess. In these cases, surgical drainage is indicated, which can be made by minimally invasive approaches, like laparoscopic drainage or imaging-guided drainage procedures [7][8][9][10][11] . Immediate surgery (laparoscopy or laparotomy) is indicated for all cases with suspected rupture of TOA.…”

Section: Introductionmentioning

confidence: 99%

Minimally invasive approach of tubo-ovarian abscesses

Silva¹,

Castro²,

Godinho³

et al. 2015

Rev. Bras. Ginecol. Obstet.

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PURPOSE: To evaluate the treatment outcome of tubo-ovarian abscesses managed by transvaginal ultrasound-guided aspiration. METHODS: Descriptive analysis of all patients with tubo-ovarian abscesses treated with a minimally invasive procedure, ultrasound-guided drainage, at the Department of Gynecology, Centro Hospitalar Vila Nova de Gaia/ Espinho, during a period of 5 years (from June 2009 to June 2014). RESULTS: Twenty-six cases were included in the study. The mean age of the study group was 42.8 years. All patients were submitted to transvaginal ultrasound-guided aspiration and sclerosis with iodated solution, as well as received broad-spectrum intravenous antibiotics. The mean time from admission to drainage was 2.5 days. Cultures for aerobic and anaerobic pathogens were positive in 14 of the 26 cases. A complete response was noted in 23 of the 26 cases. No complications or morbidity were noted as a consequence of the drainage procedures. CONCLUSION: Minimally invasive treatment of tubo-ovarian abscesses by transvaginal ultrasound-guided drainage is an effective and safe approach.

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Comparison of CT‐ or ultrasound‐guided drainage with concomitant intravenous antibiotics vs. intravenous antibiotics alone in the management of tubo‐ovarian abscesses

Abstract: Objective

Cited by 73 publications

References 20 publications

Effectiveness and Adverse Events of Early Laparoscopic Therapy versus Conservative Treatment for Tubo-Ovarian or Pelvic Abscess: A Single-Center Retrospective Cohort Study

Effectiveness and Adverse Events of Early Laparoscopic Therapy versus Conservative Treatment for Tubo-Ovarian or Pelvic Abscess: A Single-Center Retrospective Cohort Study

Surgical, Ultrasound Guided Drainage, and Medical Management of Tuboovarian Abscesses

Minimally invasive approach of tubo-ovarian abscesses

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