Acute Pelvic Inflammatory Disease: Characteristics of Patients with Gonococcal and Nongonococcal Infection and Evaluation of Their Response to Treatment with Aqueous Procaine Penicillin G and Spectinomycin Hydrochloride

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Abstract

We studied 41 women with acute gonococcal pelvic inflammatory disease and 42 women with acute nongonococcal pelvic inflammatory disease. Women with gonococcal pelvic inflammatory disease were more likely to have become ill during the first 10 days of their menstrual cycle (P < 0.05), presented themselves for treatment sooner (P < 0.05), and were more severely ill than patients with nongonococcal pelvic inflammatory disease (P < 0.05). Patients were treated with aqueous procaine penicillin G or with spectinomycin hydro-chloride for five days. Most of the patients with gonococcal disease responded to treatment. Neither drug, in the dosage employed in this study, was highly effective in the treatment of acute nongonococcal pelvic inflammatory disease. In all, 10 of 21 women with nongonococcal pelvic inflammatory disease and only one of 19 women with gonococcal pelvic inflammatory disease required retreatment for pelvic inflammatory disease within 28 days (P < 0.05). Reexamination an average of 17 months following treatment showed that women who had been treated for nongonococcal pelvic inflammatory disease were more likely to develop recurrent pelvic inflammatory disease if the episode of pelvic inflammatory disease treated in the study was not their first. Women treated for nongonococcal pelvic inflammatory disease were also less likely to become pregnant (P < 0.05).

These data, which show that gonococcal and nongonococcal pelvic inflammatory disease differ in initial clinical severity, response to treatment, and long-term complications, support the concept that gonococcal pelvic inflammatory disease and nongonococcal pelvic inflammatory disease are separate clinical entities.

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