[Ciprofloxacin/metronidazole vs. cefoxitin/doxycycline: comparison of two therapy schedules for treatment of acute pelvic infection]

Geburtshilfe Frauenheilkd. 1994 Jun;54(6):337-40. doi: 10.1055/s-2007-1022851.
[Article in German]


The efficacy and safety of two antibiotic regimens for the treatment of acute pelvic inflammatory disease (PID) was compared in a prospective and randomised study. 57 patients received either 0.2 gms ciprofloxacin intravenously b.i.d. in combination with 0.5 g metronidazole intravenously t.i.d. (n = 26), or alternatively 2 g cefoxitin intravenously t.i.d. in combination with doxycycline 0.1 g b.i.d. (n = 31). After commencing therapy intravenously, medication with ciprofloxacin, metronidazole and doxycycline was continued orally after two or three days. In the ciprofloxacin/metronidazole group, PID was found to be severe in 7, moderate in 12 and mild in 7 patients. The numbers in the cefoxitin/doxycycline group were 8, 20 and 3 respectively. The clinical result after treatment with ciprofloxacin/metronidazole was resolution of all symptoms in 24 patients and improvement in 2 others. In the cefoxitin/doxycycline treated group, resolution was found in 27 patients, improvement in 2 others. Failure occurred in 2 patients. 53 different microorganisms as the suspected cause of PID were isolated in the ciprofloxacin/metronidazole group and 56 in the cefoxitin/doxycycline group. According to our clinical and bacteriological criteria, treatment for PID was successful in 97% of the ciprofloxacin/metronidazole group and in 87% of the cefoxitin/doxycycline group. Adverse reactions were found in 4 patients in the ciprofloxacin/metronidazole treated group. Therapy had to be terminated in 3 of these patients. In the cefoxitin/doxycycline group 2 patients had adverse reactions, and therapy had to be terminated in one of these patients. According to our results, both antibiotic regimens can be recommended for the treatment of PID.

Publication types

  • Clinical Trial
  • Comparative Study
  • English Abstract
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Bacterial Infections / drug therapy*
  • Bacterial Infections / etiology
  • Bacteriological Techniques
  • Cefoxitin / administration & dosage*
  • Cefoxitin / adverse effects
  • Ciprofloxacin / administration & dosage*
  • Ciprofloxacin / adverse effects
  • Dose-Response Relationship, Drug
  • Doxycycline / administration & dosage*
  • Doxycycline / adverse effects
  • Drug Administration Schedule
  • Drug Therapy, Combination / adverse effects
  • Drug Therapy, Combination / therapeutic use
  • Female
  • Humans
  • Metronidazole / administration & dosage*
  • Metronidazole / adverse effects
  • Pelvic Inflammatory Disease / drug therapy*
  • Pelvic Inflammatory Disease / etiology
  • Prospective Studies


  • Metronidazole
  • Ciprofloxacin
  • Cefoxitin
  • Doxycycline