Cefoxitin plus doxycycline versus clindamycin plus gentamicin in hospitalized pelvic inflammatory disease patients: An experience from a tertiary hospital

Objective: To compare length of hospital stay (LOS) and surgical rate in patients hospitalized with pelvic inflammatory disease (PID) who received either cefoxitin plus doxycycline regimen or clindamycin plus gentamicin regimen. Methods: Medical records of patients hospitalized with PID from 2004 to 2011 were reviewed. Study population was women aged 14-40 years old who had a first-time, admitted diagnosis and a discharged diagnosis of PID. Patients who had prior hysterectomy, bilateral salpingectomy and were not sexually active were excluded. The patients received either intravenous cefoxitin (2 grams every 6 hours) plus oral doxycycline (100 mg twice a day) regimen or intravenous clindamycin (900 mg every 8 hours) plus gentamicin (240 mg once daily) regimen. Outcomes of interest were LOS and surgical rate. Results: Of 252 eligible participants, 141 (55.95%) received cefoxitin plus doxycycline and 111 (44.05%) received clindamycin plus gentamicin. The patients receiving cefoxitin plus doxyclycline had statistically significant lower age and less number of cases of tubo-ovarian abscess (TOA) (P < 0.05). Logistic regression showed the similar LOS and surgical rate in both groups after adjusted with age and TOA. No severe adverse effect was identified in both regimens. Conclusion: Cefoxitin plus doxycycline regimen appears as effective as clindamycin plus gentamicin regimen for treating hospitalized PID patients in terms of LOS, surgical rate and safety profile.