Cochrane · systematic review · CD010285
Antibiotic therapy for pelvic inflammatory disease
Savaris, RF, Fuhrich, DG, Maissiat, J, et al. · Cochrane Database of Systematic Reviews · 2020 · Cochrane Library
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
37
current version
GRADE rated
20
No studies
16
Included studies
NR
No studies 16 · 43.2%Ungraded 1 · 2.7%Very low 8 · 21.6%Low 7 · 18.9%Moderate 4 · 10.8%High 1 · 2.7%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Current version onlyRegimens containing macrolides (azithromycin) compared to regimens containing tetracycline (doxycycline) for pelvic inflammatory disease
Population: women with PID
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clinical cure according to criteria established by study authors Mild‐moderate PID Regimens containing macrolides (azithromycin) vs regimens containing tetracycline (doxycycline) | RR 1.18 [0.89, 1.55] | NR | Very low Downgraded: risk of bias, imprecision, inconsistency |
Clinical cure according to criteria established by study author Mild‐moderate PID Regimens containing macrolides (azithromycin) vs regimens containing tetracycline (doxycycline) | RR 1.35 [1.1, 1.67] | NR | Moderate Downgraded: imprecision |
Clinical cure according to criteria established by study authors Severe PID Regimens containing macrolides (azithromycin) vs regimens containing tetracycline (doxycycline) | RR 1 [0.96, 1.05] | NR | Low Downgraded: risk of bias |
Adverse events: any antibiotic‐related adverse event leading to discontinuation of therapy Regimens containing macrolides (azithromycin) vs regimens containing tetracycline (doxycycline) | RR 0.71 [0.38, 1.34] | NR | Low Downgraded: risk of bias, imprecision |
Microbiological clearance Regimens containing macrolides (azithromycin) vs regimens containing tetracycline (doxycycline) | RR 1.02 [0.98, 1.06] | NR | Ungraded |
Laparoscopic evidence of resolution of PID based on physician opinion Regimens containing macrolides (azithromycin) vs regimens containing tetracycline (doxycycline) | no estimate extracted | NR | No studies |
Length of stay (for inpatient care) Regimens containing macrolides (azithromycin) vs regimens containing tetracycline (doxycycline) | no estimate extracted | NR | No studies |
Fertility outcome Regimens containing macrolides (azithromycin) vs regimens containing tetracycline (doxycycline) | no estimate extracted | NR | No studies |
Regimens containing quinolone compared to regimens containing cephalosporins for pelvic inflammatory disease
Population: women with PID
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clinical cure according to criteria established by study authors Mild‐moderate PID Regimens containing quinolone vs regimens containing cephalosporins | RR 1.05 [0.98, 1.14] | NR | Low Downgraded: risk of bias, imprecision |
Clinical cure according to criteria established by study authors Severe PID Regimens containing quinolone vs regimens containing cephalosporins | RR 1.06 [0.91, 1.23] | NR | Low Downgraded: risk of bias, imprecision |
Adverse events: any antibiotic‐related adverse event leading to discontinuation of therapy Regimens containing quinolone vs regimens containing cephalosporins | RR 2.24 [0.52, 9.72] | NR | Very low Downgraded: risk of bias, imprecision |
Microbiological clearance Regimens containing quinolone vs regimens containing cephalosporins | RR 0.95 [0.84, 1.08] | NR | Very low Downgraded: risk of bias, imprecision |
Laparoscopic evidence of resolution of PID based on physician opinion Regimens containing quinolone vs regimens containing cephalosporins | no estimate extracted | NR | No studies |
Length of stay (for inpatient care) Regimens containing quinolone vs regimens containing cephalosporins | no estimate extracted | NR | No studies |
Fertility outcome Regimens containing quinolone vs regimens containing cephalosporins | no estimate extracted | NR | No studies |
Regimens containing nitroimidazole compared to no nitroimidazole for pelvic inflammatory disease
Population: women with PID
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clinical cure according to criteria established by study authors Mild‐moderate PID Regimens containing nitroimidazole vs no nitroimidazole | RR 1.02 [0.95, 1.09] | NR | Moderate Downgraded: risk of bias, inconsistency |
Clinical cure according to criteria established by study authors Mild‐moderate PID Regimens containing nitroimidazole vs no nitroimidazole | RR 1.05 [1, 1.12] | NR | High |
Clinical cure according to criteria established by study authors Severe PID Regimens containing nitroimidazole vs no nitroimidazole | RR 0.96 [0.92, 1.01] | NR | Moderate Downgraded: risk of bias |
Adverse events: any antibiotic‐related adverse event leading to discontinuation of therapy Regimens containing nitroimidazole vs no nitroimidazole | RR 1.05 [0.69, 1.61] | NR | Low Downgraded: risk of bias, imprecision |
Microbiological clearance Regimens containing nitroimidazole vs no nitroimidazole | no estimate extracted | NR | No studies |
Laparoscopic evidence of resolution of PID based on physician opinion Regimens containing nitroimidazole vs no nitroimidazole | no estimate extracted | NR | No studies |
Length of stay (for inpatient care) Regimens containing nitroimidazole vs no nitroimidazole | no estimate extracted | NR | No studies |
Fertility outcome Regimens containing nitroimidazole vs no nitroimidazole | no estimate extracted | NR | No studies |
Regimens containing clindamycin plus aminoglycoside compared to regimens containing quinolone for pelvic inflammatory disease
Population: women with PID
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clinical cure according to criteria established by authors Mild‐moderate PID Regimens containing clindamycin plus aminoglycoside vs regimens containing quinolone | RR 0.88 [0.69, 1.13] | NR | Very low Downgraded: risk of bias, imprecision |
Clinical cure according to criteria established by authors Severe PID Regimens containing clindamycin plus aminoglycoside vs regimens containing quinolone | RR 1.02 [0.87, 1.19] | NR | Low Downgraded: risk of bias, imprecision |
Adverse events: any antibiotic‐related adverse event leading to discontinuation of therapy Regimens containing clindamycin plus aminoglycoside vs regimens containing quinolone | RR 0.21 [0.02, 1.72] | NR | Very low Downgraded: risk of bias, imprecision |
Microbiological clearance Regimens containing clindamycin plus aminoglycoside vs regimens containing quinolone | RR 1.08 [0.85, 1.36] | NR | Very low Downgraded: risk of bias, imprecision |
Laparoscopic evidence of resolution of PID based on physician opinion Regimens containing clindamycin plus aminoglycoside vs regimens containing quinolone | no estimate extracted | NR | No studies |
Length of stay (for inpatient care) Regimens containing clindamycin plus aminoglycoside vs regimens containing quinolone | no estimate extracted | NR | No studies |
Fertility outcome Regimens containing clindamycin plus aminoglycoside vs regimens containing quinolone | no estimate extracted | NR | No studies |
Regimens containing clindamycin plus aminoglycoside compared to regimens containing cephalosporin for pelvic inflammatory disease
Population: women with PID
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clinical cure according to criteria established by authors Mild‐moderate PID Regimens containing clindamycin plus aminoglycoside vs regimens containing cephalosporin | RR 1.02 [0.95, 1.09] | NR | Low Downgraded: risk of bias, imprecision |
Clinical cure according to criteria established by authors Severe PID Regimens containing clindamycin plus aminoglycoside vs regimens containing cephalosporin | RR 1 [0.95, 1.06] | NR | Moderate Downgraded: risk of bias |
Adverse events: any antibiotic‐related adverse event leading to discontinuation of therapy Regimens containing clindamycin plus aminoglycoside vs regimens containing cephalosporin | RR 0.78 [0.18, 3.42] | NR | Very low Downgraded: risk of bias, imprecision |
Microbiological clearance Regimens containing clindamycin plus aminoglycoside vs regimens containing cephalosporin | RR 1.02 [0.94, 1.1] | NR | Very low Downgraded: risk of bias, imprecision |
Laparoscopic evidence of resolution of PID based on physician opinion Regimens containing clindamycin plus aminoglycoside vs regimens containing cephalosporin | no estimate extracted | NR | No studies |
Length of stay (for inpatient care) Regimens containing clindamycin plus aminoglycoside vs regimens containing cephalosporin | no estimate extracted | NR | No studies |
Fertility outcome Regimens containing clindamycin plus aminoglycoside vs regimens containing cephalosporin | no estimate extracted | NR | No studies |
Macrolides (azithromycin) compared to tetracycline (doxycycline) for pelvic inflammatory disease (PID)
Population: women with PID
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clinical cure according to criteria established by study authors Mild‐moderate PID Macrolides (azithromycin) vs tetracycline (doxycycline) | RR 1.18 [0.89, 1.55] | NR | Very low Downgraded: risk of bias |
Clinical cure according to criteria established by study authors Mild‐moderate PID Macrolides (azithromycin) vs tetracycline (doxycycline) | RR 1.35 [1.1, 1.67] | NR | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Clinical cure according to criteria established by study authors Severe PID Macrolides (azithromycin) vs tetracycline (doxycycline) | RR 1 [0.96, 1.05] | NR | Low Downgraded: risk of bias, imprecision, inconsistency |
Adverse events: any antibiotic‐related adverse event leading to discontinuation of therapy. Macrolides (azithromycin) vs tetracycline (doxycycline) | RR 0.71 [0.38, 1.34] | NR | Low Downgraded: risk of bias |
Quinolone compared to cephalosporins for pelvic inflammatory disease
Population: women with PID
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clinical cure according to criteria established by study authors Mild‐moderate PID Quinolone vs cephalosporins | RR 1.04 [0.98, 1.1] | NR | Low Downgraded: risk of bias |
Clinical cure according to criteria established by study authors Severe PID Quinolone vs cephalosporins | RR 1.06 [0.91, 1.23] | NR | Low Downgraded: risk of bias |
Adverse events: any antibiotic‐related adverse event leading to discontinuation of therapy Quinolone vs cephalosporins | RR 2.24 [0.52, 9.72] | NR | Very low Downgraded: risk of bias |
Nitroimidazole compared to no nitroimidazole for pelvic inflammatory disease
Population: women with PID
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clinical cure according to criteria established by study authors Mild‐moderate PID Nitroimidazole vs no nitroimidazole | RR 1.01 [0.93, 1.1] | NR | Moderate Downgraded: risk of bias |
Clinical cure according to criteria established by study authors Mild‐moderate PID Nitroimidazole vs no nitroimidazole | RR 1.06 [0.98, 1.15] | NR | High |
Clinical cure according to criteria established by study authors Severe PID Nitroimidazole vs no nitroimidazole | RR 0.96 [0.92, 1.01] | NR | Moderate Downgraded: risk of bias |
Adverse events: any antibiotic‐related adverse event leading to discontinuation of therapy Nitroimidazole vs no nitroimidazole | RR 1 [0.63, 1.59] | NR | Low Downgraded: risk of bias |
Clindamycin plus aminoglycoside compared to quinolone for pelvic inflammatory disease
Population: women with PID
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clinical cure according to criteria established by authors Mild‐moderate PID Clindamycin plus aminoglycoside vs quinolone | RR 0.88 [0.69, 1.13] | NR | Very low Downgraded: risk of bias |
Clinical cure according to criteria established by authors Severe PID Clindamycin plus aminoglycoside vs quinolone | RR 1.02 [0.87, 1.19] | NR | Low Downgraded: risk of bias, imprecision |
Adverse events: any antibiotic‐related adverse event leading to discontinuation of therapy Clindamycin plus aminoglycoside vs quinolone | RR 0.21 [0.02, 1.72] | NR | Very low Downgraded: risk of bias |
Clindamycin plus aminoglycoside compared to cephalosporin for pelvic inflammatory disease
Population: women with PID
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clinical cure according to criteria established by authors Mild‐moderate PID Clindamycin plus aminoglycoside vs cephalosporin | RR 1.02 [0.95, 1.09] | NR | Low Downgraded: risk of bias |
Clinical cure according to criteria established by authors Severe PID Clindamycin plus aminoglycoside vs cephalosporin | RR 1 [0.95, 1.06] | NR | Moderate Downgraded: risk of bias |
Adverse events: any antibiotic‐related adverse event leading to discontinuation of therapy Clindamycin plus aminoglycoside vs cephalosporin | RR 0.78 [0.18, 3.42] | NR | Very low Downgraded: risk of bias |