Pelvic Inflammatory Disease

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Cefotetan and cefoxitin are two cephamycin antibiotics (typically categorized as second generation cephalosporins) that are unique in providing anaerobic coverage.

Pelvic inflammatory disease(PID) describes infection of the female upper genital tract. These infections are commonly polymicrobial and can include sexually transmitted (N. gonorrhoeae, C. trachomatis) as well as many other organisms including G. vaginalis, Haemophilus influenzae, enteric Gram-negative rods, Streptococcus agalactiae, M. hominis, U. urealyticum, M. genitalium and CMV.

Symptoms can be non-specific and treatment for PID should be initiated for sexually active young women with pelvic or lower abdominal pain that have uterine tenderness, adnexal tenderness or cervical motion tenderness.

Broad spectrum empiric therapy is indicated and parenteral options include

  • Cefotetan (IV) and Doxycycline (oral or IV)
  • Cefoxitin (IV) and Doxycycline (oral or IV)
  • Clindamycin(IV) and Gentamicin(IV or IM)


Workowski KA, Bolan GA; Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep. 2015 Jun 5;64(RR-03):1-137.PMID: 26042815