Principles of antimicrobial therapy for patients with acute adnexitis

Acute adnexitis is inflammation of both salpingitis and oophoritis. Salpingitis is the most common type of acute pelvic inflammatory disease. The ovaries are adjacent to the fallopian tubes. When inflammation of the fallopian tubes continues to spread, it often causes oophoritis. Patients should follow the following treatment principles when choosing antibacterial drugs for treatment.

Principles of antimicrobial therapy for patients with acute adnexitis

1. Penicillins: Representative drugs include penicillin G, with a dose of 2.4 to 12 million U/d intravenous drip, mainly targeting Gram-positive or Gram-negative cocci; ampicillin, with a dose of 2 to 6 g/d intravenous drip, mainly targeting Escherichia coli; amoxicillin and clavulanate potassium, with a dose of 1.2 to 2.4 g/d intravenous drip, has a broader antibacterial spectrum and can inhibit the activity of β-lactamase.

2. Aminoglycoside antibiotics: They are effective against Gram-negative bacteria. Representative drugs include gentamicin 160,000 to 240,000 U/d intravenous drip; amikacin 0.4 to 0.8 g/d intravenous drip; amikacin 0.2 to 0.4 g/d intravenous drip; tobramycin 80 to 240 mg/d intravenous drip.

3. Macrolide antibiotics: have strong effects on Gram-positive bacteria and Chlamydia trachomatis. Representative drugs include erythromycin 1.2-1.8 g/d intravenous drip; josamycin 800-1200 mg/d, oral; roxithromycin 300-450 mg/d, oral; clarithromycin 500-1000 mg/d, intravenous drip; azithromycin 500 mg/d, oral.

4. Others: Metronidazole 1.0-2.0 g/d, intravenous drip; tinidazole 0.8 g/d, intravenous drip; cytomycin 1.2-1.8 g/d, intravenous drip; clindamycin 0.6-1.2 g/d, intravenous drip; doxycycline 200 mg/d, oral; minocycline 200 mg/d, oral.