PELVIC INFLAMMATORY DISEASE - METAANALYSIS OF ANTIMICROBIAL REGIMEN EFFICACY

An extensive body of literature has investigated the efficacy of antim icrobial regimens used to treat pelvic inflammatory disease (PID), lea ving many clinicians confused about how to choose among them. This stu dy provides a formal appraisal of these reports. Thirty-four treatment studies published between 1966 and 1992 were identified, using Medlin e and bibliographies, and evaluated qualitatively and quantitatively i n a metaanalysis. Twenty-one studies met the criteria for inclusion in this evaluation: appropriate system for making the diagnosis of PID, standardized assessment of clinical outcome, and entry and follow-up e valuation for lower genital tract infection with Neisseria gonorrhoeae and Chlamydia trachomatis. This metaanalysis identifies a considerabl e range of quality in study methods and research design and underscore s the limitations inherent in comparing such data. Despite this, a num ber of antimicrobial regimens appear to have very good short-term clin ical and microbiologic efficacy. Pooled clinical cure rates range from 75% to 94% and pooled microbiologic cure rates range from 71% to 100% . A cost comparison is provided, and future research priorities are su ggested.