Pelvic Inflammatory Disease

Warning

If proven or high risk of STI, refer to GUM for treatment and partner notification.

Exclude pregnancy in women with pelvic pain.

Intravenous antibiotic therapy is recommended in more severe clinical disease: pyrexia >38◦C, tubo-ovarian abscess or pelvic peritonitis. Refer by phone to gynaecology. 

Drug details

Drug

Mild to moderate:

ORAL Metronidazole

Dosage

400mg

Duration

twice daily 14 days

Drug

PLUS

ORAL Doxycycline

Dosage

100mg

Duration

twice daily 14 days

Drug

Second line:

ORAL Metronidazole

Dosage

400mg

Duration

twice daily 14 days

Drug

PLUS

ORAL Ofloxacin*

Dosage

400mg

Duration

twice daily 14 days

Drug

First line for M. genitalium associated PID (refer to GUM):

ORAL Moxifloxacin*

Dosage

400mg

Duration

once daily 14 days

Drug

If gonorrhoea suspected:

Refer to GUM for IM Ceftriaxone

Dosage

1g

Duration

single dose

Drug

PLUS

oral Metronidazole

Dosage

400mg

Duration

twice daily 14 days

Drug

PLUS

oral Doxycycline

Dosage

100mg

Duration

twice daily 14 days

*Consider safety issues with quinolones

Editorial Information

Last reviewed: 18/05/2022

Next review date: 18/05/2025

Author(s): NHS Lanarkshire Antimicrobial Management Committee, Dr Dundas, Dr Hylands, S McCormick, Heather Boyle.

Version: V1

Approved By: AMC; ADTC

Reviewer name(s): NHS Lanarkshire Antimicrobial Management Committee, Heather Boyle.

Document Id: June 2022