Management of PID: are we getting it right?

Management of PID: are we getting it right?

M. Gupta (1), A. Kasliwal (2)

Department of Genito Urinary Medicine, Royal Liverpool Hospital, Liverpool,

UK (1); Palatine Centre, Manchester, UK (2)

Objective: To establish from the Gynaecology Departments if women with

suspected Pelvic inflammatory Disease (PID) are being managed appropriately.

Method: The Junior Doctor on call for Gynaecology in all the hospitals

in the Northwest region of England and North Wales was interviewed by telephone.

This was a structured interview using a questionnaire.

Results: All the doctors interviewed routinely took a high vaginal

swab (HVS) for culture and sensitivity and an endocervical swab for Chlamydia (CtS).

Only 45% of the doctors used the correct technique of taking the endocervical

swab. 34% of the doctors took a second endocervical swab for gonorrhoea in

charcoal medium. Out of office hours, 21% of doctors stored all the swabs at

room temperature, 38% stored them in the refrigerator and 41% did not know how

they were stored in their hospital. The choice and duration of antibiotic

treatment varied greatly from hospital to hospital. It was the policy in 21% of

the units to refer all women with suspected PID to the Genito Urinary Medicine

(GUM) clinic, whereas 55% of the units referred only those women with a positive

test result.

Conclusion: This study suggests deficiencies in the management of

women with suspected PID in the hospital setting in the region surveyed. It is

essential that protocols for diagnostic tests, treatment and follow-up including

referral to GUM clinic (for screening sexually transmitted infections and sexual

contact tracing) are drawn up according to the National Guidelines. Adherence to

protocols may avoid serious sequelae such as infertility, chronic pelvic pain

and ectopic pregnancy.

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