Trial reportClinical infectious diseases : an official publication of the Infectious Diseases Society of America2021
A Randomized Controlled Trial of Ceftriaxone and Doxycycline, With or Without Metronidazole, for the Treatment of Acute Pelvic Inflammatory Disease.
Trial report in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01160640 (The Importance of Anti-anaerobic Therapy for Acute PID), which is not on this map. Cited by 47 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
The Importance of Anti-anaerobic Therapy for Acute PID
Who cites it
47 citing papers in PubMed, 1 synthesis or guideline pooled it, 77 citations in OpenAlex.
- Sexually Transmitted Infections Treatment Guidelines, 2021.MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports · 2021Guideline
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- Evaluation of Alinity m STI Assay for Simultaneous Detection of Chlamydia trachomatis , Neisseria gonorrhoeae , Trichomonas vaginalis , and Mycoplasma genitalium in Female Urogenital Specimens.Sexually transmitted diseases · 2026Article
- The Role of Antimicrobial Susceptibility and Resistance Testing forOpen forum infectious diseases · 2026Article
- Systematic Review and Meta-analysis of the Association Between Mycoplasma genitalium and Pelvic Inflammatory Disease (PID).Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Article
- Eravacycline: From broad-spectrum coverage to novel clinical applications.Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2026Review
- Therapeutic potential and mechanisms of plant metabolites in endometritis: a comprehensive review.Frontiers in pharmacology · 2026Review
- Prognostic Value of the CALLY Index in Hospitalized Patients with Pelvic Inflammatory Disease and Tubo-Ovarian Abscess.International journal of women's health · 2026Article
- miRNA/mRNA analysis of increased TGF-β pathways drive epithelial-mesenchymal transition and regulatory T cell differentiation.Frontiers in immunology · 2026Article
- Limited Role ofObstetrics and gynecology international · 2026Article
- Gut-reproduction axis: a new perspective on understanding pelvic inflammatory disease.Frontiers in microbiology · 2026Review
- Beyond Inflammation: A Comprehensive Outlook on the Integrated Traditional Chinese and Western Medicine Treatment of Pelvic Inflammatory Disease.International journal of general medicine · 2026Review
- Mycoplasma Genitalium - Where are we at?Current HIV/AIDS reports · 2025Review
- Efficacy and tolerability of the combination of minocycline and metronidazole for macrolide-resistant Mycoplasma genitalium.The Journal of antimicrobial chemotherapy · 2025Article
- miRNA/mRNA analysis of increased TGF-β pathways drive epithelial-mesenchymal transition and regulatory T cell differentiation.bioRxiv : the preprint server for biology · 2025Article
- Comprehensive Assessment of Genital Infections and Reproductive Health in Women Visiting a Fertility Clinic in Warangal, India-A Case-Control Study.Health science reports · 2025Article
- Clinical efficacy of levofloxacin hydrochloride plus metronidazole in the treatment of pelvic inflammatory disease: a retrospective analysis.American journal of translational research · 2025Article
- Trends in infections detected in women with cervicitis over a decade.Frontiers in reproductive health · 2025Article
- Therapeutic potential of botanical drugs and their metabolites in the treatment of pelvic inflammatory disease.Frontiers in pharmacology · 2025Review
- The importance of understanding pelvic inflammatory disease as a polymicrobial infection.The Lancet regional health. Europe · 2024Article
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundAnaerobic organisms are important pathogens in acute pelvic inflammatory disease (PID). The currently recommended PID regimen of a single dose of ceftriaxone and doxycycline for 14 days has limited anaerobic activity. The need for broader anaerobic coverage is unknown and concerns have been raised about metronidazole tolerability.
methodsWe conducted a randomized, double-blind, placebo-controlled trial comparing ceftriaxone 250 mg intramuscular single dose and doxycycline for 14 days, with or without 14 days of metronidazole in women with acute PID. The primary outcome was clinical improvement at 3 days following enrollment. Additional outcomes at 30 days following treatment were the presence of anaerobic organisms in the endometrium, clinical cure (absence of fever and reduction in tenderness), adherence, and tolerability.
resultsWe enrolled 233 women (116 to metronidazole and 117 to placebo). Clinical improvement at 3 days was similar between the 2 groups. At 30 days following treatment, anaerobic organisms were less frequently recovered from the endometrium in women treated with metronidazole than placebo (8% vs 21%, P < .05) and cervical Mycoplasma genitalium was reduced (4% vs 14%, P < .05). Pelvic tenderness was also less common among women receiving metronidazole (9% vs 20%, P < .05). Adverse events and adherence were similar in each treatment group.
conclusionsIn women treated for acute PID, the addition of metronidazole to ceftriaxone and doxycycline was well tolerated and resulted in reduced endometrial anaerobes, decreased M. genitalium, and reduced pelvic tenderness compared to ceftriaxone and doxycycline. Metronidazole should be routinely added to ceftriaxone and doxycycline for the treatment of women with acute PID. CLINICAL TRIALS REGISTRATION: NCT01160640.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.