Prolonged Aminoglycoside Treatment for Pelvic Inflammatory Disease Associated Ovarian Carcinoma

Abstract

Pelvic actinomycosis constitutes one of the curiosities of gynecology. In this present investigation the presence of actinomycetes infection among Intrauterine device (IUD) users and its correlation correlated with the development of Pelvic Inflammatory Disease (PID) and ovarian carcinoma was studied. Endocervical swabs were obtained from ovarian carcinoma, IUD users, non-users and processed to isolate actinomycetes on actinomycetes isolation agar. The isolation rate was found to be increased among IUD users who were clinically diagnosed to have PID (52.9%) followed by ovarian carcinoma cases who were prior users of IUD (44.4%). Compared to healthy non-IUD users, IUD users with PID experienced a 158 fold statistically significant increased risk of actinomycetes infection (OR = 158.63, 95% CI = 17.84, 161.11) followed by ovarian carcinoma patients with IUDs (OR = 112.80, 95% CI = 10.59, 120.02). The isolates showed high resistance against penicillin, clindamycin and erythromycin and low resistance against tetracycline, linezolid and gentamycin. The use of IUDs facilitates the colonization by actinomycetes which in turn lead to PID and pelvic actinomycosis. Further the pelvic actinomycosis simulates pelvic malignancies. If chronic actinomycetes infection are encountered, the patients should be given long term therapy with aminoglycoside antibiotics and if a pelvic mass is evident aggressive and prolonged antibiotic therapy with surgical intervention is required.