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Abstract：
This review of the treatment of uncomplicated pelvic inflammatory disease (PID) focuses on the susceptibility profile of the main microbiological causes as well as on the advantages and inconvenients of relevant antibiotics. As bacterial resistance is expanding in the community, the rules of adequate antibiotic prescribing are integrated in the treatment proposals. While the pathogenic role of anaerobic bacteria in uncomplicated PID remains discussed, the choice to provide anaerobes coverage is proposed. Thus, the antibiotic treatment has to cover Chamydia trachomatis, Neisseria gonorrhoeae, anaerobes as well as Streptococcus spp, gram negative bacteria and the ermerging Mycoplasma genitalium. On the basis of published trials and good practice antibiotic usage, the ceftriaxone-doxycycline-metronidazole combination has been selected as the first line regimen. Fluoroquinolones (moxifloxacin alone, or levofloxacin or ofloxacin combined with metronidazole) are proposed as alternatives because of their ecological impact and their side effects leading to restricted usage. When fluoroquinolone are used, ceftriaxone should be added in case of possible sexually transmitted infection. When detected, M. genitalium should be treated by moxifloxacin. Moreover, this review highlights the need to better describe the microbiological epidemiology of uncomplicated PID in France or Europe.
摘要：
本文对简单的盆腔炎（PID）的治疗进行了综述，重点介绍了主要微生物原因的敏感性以及相关抗生素的优点和不便之处。随着细菌耐药性在社区中的扩大，适当的抗生素处方规则被纳入治疗建议中。虽然厌氧菌在不复杂的PID中的致病作用仍在讨论中，提出了提供厌氧菌覆盖的选择。因此，抗生素治疗必须覆盖沙眼香菇，淋病奈瑟菌,厌氧菌以及链球菌，革兰氏阴性菌和生殖道支原体。根据已发表的试验和抗生素使用的良好做法，头孢曲松-多西环素-甲硝唑联合用药被选择为一线治疗方案.氟喹诺酮类药物（单独莫西沙星，或左氧氟沙星或氧氟沙星与甲硝唑联合使用）被提议作为替代品，因为它们对生态的影响和副作用导致使用受限。当使用氟喹诺酮时，如果可能发生性传播感染，应添加头孢曲松。检测到时,生殖支原体应使用莫西沙星治疗。此外，这篇综述强调有必要更好地描述法国或欧洲不复杂PID的微生物流行病学.
