A comparison of treatment outcomes for levofloxacin versus doxycycline plus metronidazole for first-line treatment of uncomplicated pelvic inflammatory disease

Background: Pelvic inflammatory disease (PID), a common condition among women of reproductive age caused by various aerobic and anaerobic organisms, may sometimes lead to complications such as infertility, ectopic pregnancy, and chronic pelvic pain. Moxifloxacin is a broad-spectrum bactericidal acting against many Gram-positive, Gram-negative aerobic organisms and anaerobes. Rapid absorption and high bioavailability allow single daily dosing and improves compliance.
Aims and Objectives: The present study was done to compare the treatment outcomes for levofloxacin versus doxycycline plus metronidazole for first-line treatment of uncomplicated in PID patients.
Materials and Methods: This was hospital-based prospective, randomized, double-blind study conducted at gynecology outpatient department of Gouri Devi Institute of Medical Sciences and Hospital, Durgapur, West Bengal, from January 2019 to December 2019. The study group was divided into Group A 50 cases (receiving levofloxacin) and Group B 50 cases (receiving doxycycline plus metronidazole) were included in the study. Template was generated and analysis was done on SPSS software.
Results: Among 50 patients of each group, mean age of the patients of Group A was 27.80 (±3.58) and mean age of Group B was 27.57 (±4.51). Mean parity of the patients of Group A was 1.93 (±1.11) and mean parity of Group B was 2.07 (±1.11). Past H/O PID in Group A was 17 and in Group B was 19. Visual analog scale (VAS) pain score of Group A was 3.80 (±1.827) and VAS pain score of Group B was 3.97 (±1.671). VAS pain score was 1.10 (±0.960) in Group A and 2.63 (±1.426) in Group B. VAS vaginal discharge was 1.40 (±1.276) in Group A and 3.00 (±1.619) in Group B.
Conclusion: The management of uncomplicated PID requires broad-spectrum antibiotic regimens to cover all potential pathogens. This study confirmed that fluoroquinolones, specifically levofloxacin, are effective and well tolerated in the treatment of uncomplicated PID.