Do short-term markers of treatment efficacy predict long-term sequelae of pelvic inflammatory disease?

Am J Obstet Gynecol. 2008 Jan;198(1):30.e1-7. doi: 10.1016/j.ajog.2007.05.021.


Objective: This study was undertaken to assess whether short-term markers, often used to measure clinical cure after treatment for pelvic inflammatory disease, predict sequelae of lack of pregnancy, recurrent pelvic inflammatory disease, and chronic pelvic pain.

Study design: Women with mild-to-moderate pelvic inflammatory disease were assessed after treatment initiation at 5 days for tenderness (n = 713) and at 30 days for tenderness, cervical infections and endometritis (n = 298). Pregnancy, recurrent pelvic inflammatory disease, and chronic pelvic pain were evaluated after 84 months, on average.

Results: Pelvic tenderness at 5 and at 30 days significantly elevated the risk for developing chronic pelvic pain; tenderness at 30 days was also significantly associated with recurrent pelvic inflammatory disease. However, pelvic tenderness at 5 and at 30 days was only modestly clinically predictive of chronic pelvic pain or recurrent pelvic inflammatory disease (positive predictive values 22.1-66.9%). No short-term marker significantly influenced the likelihood of achieving a pregnancy.

Conclusion: Tenderness at 5 or 30 days did not accurately predict the occurrence of pelvic inflammatory disease-related reproductive morbidities.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Administration, Oral
  • Adolescent
  • Adult
  • Cefoxitin / administration & dosage*
  • Dose-Response Relationship, Drug
  • Doxycycline / administration & dosage*
  • Drug Administration Schedule
  • Drug Therapy, Combination
  • Female
  • Follow-Up Studies
  • Humans
  • Infertility, Female
  • Inflammation Mediators / analysis
  • Infusions, Intravenous
  • Pain Measurement
  • Pelvic Inflammatory Disease / diagnosis*
  • Pelvic Inflammatory Disease / drug therapy*
  • Predictive Value of Tests
  • Probability
  • Probenecid / administration & dosage*
  • Proportional Hazards Models
  • Recurrence
  • Severity of Illness Index
  • Time Factors
  • Treatment Outcome


  • Inflammation Mediators
  • Cefoxitin
  • Doxycycline
  • Probenecid