Pelvic inflammatory disease in the adolescent and young adult: An update

Greydanus, Donald E.; Cabral, Maria Demma; Patel, Dilip R.

doi:10.1016/j.disamonth.2021.101287

Cited by 23 publications

(20 citation statements)

References 494 publications

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“…In most cases, it is considered a sexually transmitted disease, and Neisseria gonorrhoeae , Chlamydia trachomatis , and Mycoplasma genitalium are the commonly involved microorganisms. The main risk factors for its development are the period of adolescence, sexual promiscuity, immunological immaturity, or risky sexual practices [ 2 , 3 ].…”

Section: Introductionmentioning

confidence: 99%

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An Adolescent Female With Acute Abdominal Pain: A Rare Case in Pediatrics

Pérez-Arenas¹,

Cáceres²,

García-Plata³

et al. 2023

Cureus

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We present the case of a 13-year-old female with a 48-hour history of diffuse abdominal pain, fever, nausea, and vomiting, with worsening in the last few hours. On examination, she had signs of acute abdomen, and laboratory tests showed elevated acute phase reactants (APR). Abdominal ultrasound excluded acute appendicitis. A history of risky sexual behavior was reported, so pelvic inflammatory disease (PID) was considered. Although appendicitis is the most common cause of acute abdomen in adolescents, PID should be suspected in adolescents with risk factors. Prompt treatment is necessary to avoid possible complications and sequelae.

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Section: Introductionmentioning

confidence: 99%

“…The latest data from Western countries show that about 1%-2% of sexually active females aged 15-24 years are diagnosed with PID, and this incidence is higher in the USA and in lower socio-economic classes [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

An Adolescent Female With Acute Abdominal Pain: A Rare Case in Pediatrics

Pérez-Arenas¹,

Cáceres²,

García-Plata³

et al. 2023

Cureus

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“…2 However, compliance with multiple antibiotic regimens for uPID is poor, particularly in adolescents and those given complex, prolonged treatment regimens, which would likely lead to treatment failure. 10,11 Moxifloxacin is an 8-methoxy-fluoroquinolone, which characteristically exhibits broad-spectrum antibacterial and bactericidal activity, and is effective against Gram-positive and Gram-negative aerobic organisms, anaerobes, Chlamydia spp. and genital mycoplasmas.…”

Section: Introductionmentioning

confidence: 99%

Moxifloxacin monotherapy for treatment of uncomplicated pelvic inflammatory disease: A systematic review and meta‐analysis with trial sequential analysis of randomized controlled trials

Chen,

Dong,

Hong

et al. 2023

Pharmacoepidemiology and Drug

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PurposeThe aim of this study was to evaluate the efficacy and safety of moxifloxacin monotherapy for the treatment of uncomplicated pelvic inflammatory disease (uPID).MethodsThe literatures from PubMed, ScienceDirect, Google Scholar, Cochrane library and the http://clinicaltrials.gov/ were retrieved until February 2023. Only randomized controlled trials (RCTs) comparing the efficacy and safety of moxifloxacin with other antibiotics for treating uPID were included. The primary outcomes were clinical cure rate (CCR), bacteriological success rates (BSR) and risk of drug‐related adverse events (AEs). We used random‐effects modelled meta‐analysis, trial sequential analysis, and the Grading of Recommendations Assessment, Development, and Evaluation. This study was registered in the International Prospective Register of Systematic Reviews (registration number: CRD42023428751).ResultsA total of four RCTs that enrolled 3201 women patients with uPID were included. In the per‐protocol populations, no significant difference was observed between patients given moxifloxacin and those given other antibiotics with regard to CCR at test‐of‐cure (TOC) (2485 patients, odds ratio [OR] = 0.84, 95% confidence interval [CI] 0.68–1.04, p = 0.12). Similarly, there was no statistically significant difference between patients given moxifloxacin and those given other antibiotics in terms of BSR at TOC (471 patients, OR = 1.17, 95% CI 0.70–1.96, p = 0.56) in the microbiologically valid population. However, drug‐related AEs occurred less frequently with moxifloxacin than with other antibiotics (2973 patients, OR = 0.74, 95% CI 0.64–0.86, p < 0.0001), especially gastrointestinal AEs (2973 patients, OR = 0.59, 95% CI 0.47–0.74, p < 0.00001).ConclusionsIn the treatment of uPID, moxifloxacin monotherapy can achieve similar efficacy as other combination therapy regimens. Moreover, moxifloxacin had a better safety profile than that of comparators. Based on its additional advantages (i.e., better safety profile, no dosage adjustment and better compliance), moxifloxacin may be a more fascinating option compared with the currently used regimens.

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“…It should be noted that in 1990 the estimated costs for pelvic inflammatory disease caused by CT, and its complications (such as infertility), cost USD 4.2 billion [ 32 ]. Even though this number has decreased over the years with the implementation of Chlamydia screening programs, the expenditure is still striking [ 33 ].…”

Section: Introductionmentioning

confidence: 99%

Chlamydia trachomatis as a Current Health Problem: Challenges and Opportunities

Rodrigues

Sousa²,

Vale

2022

Diagnostics

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Chlamydia is one of the most common sexually transmitted bacterial infections (STIs) worldwide. It is caused by Chlamydia trachomatis (CT), which is an obligate intracellular bacterium. In some cases, it can occur in coinfection with other parasites, increasing the pathologic potential of the infection. The treatment is based on antibiotic prescription; notwithstanding, the infection is mostly asymptomatic, which increases the risk of transmission. Therefore, some countries have implemented Chlamydia Screening Programs in order to detect undiagnosed infections. However, in Portugal, there is no CT screening plan within the National Health Service. There is no awareness in the general healthcare about the true magnitude of this issue because most of the methods used are not Nucleic Acid Amplification Technology-based and, therefore, lack sensitivity, resulting in underreporting infection cases. CT infections are also associated with possible long-term severe injuries. In detail, persistent infection triggers an inflammatory milieu and can be related to severe sequels, such as infertility. This infection could also trigger gynecologic tumors in women, evidencing the urgent need for cost-effective screening programs worldwide in order to detect and treat these individuals adequately. In this review, we have focused on the success of an implemented screening program that has been reported in the literature, the efforts made concerning the vaccine discovery, and what is known regarding CT infection. This review supports the need for further fundamental studies in this area in order to eradicate this infection and we also suggest the implementation of a Chlamydia Screening Program in Portugal.

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Pelvic inflammatory disease in the adolescent and young adult: An update

Cited by 23 publications

References 494 publications

An Adolescent Female With Acute Abdominal Pain: A Rare Case in Pediatrics

An Adolescent Female With Acute Abdominal Pain: A Rare Case in Pediatrics

Moxifloxacin monotherapy for treatment of uncomplicated pelvic inflammatory disease: A systematic review and meta‐analysis with trial sequential analysis of randomized controlled trials

Chlamydia trachomatis as a Current Health Problem: Challenges and Opportunities

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