Effect of human immunodeficiency virus-1 infection on treatment outcome of acute salpingitis
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Date
2006Author
Mugo, NR
Kiehlbauch, JA
Nguti, R
Meier, A
Gichuhi, JW
Stamm, WE
Cohen, CR
Type
ArticleLanguage
enMetadata
Show full item recordAbstract
OBJECTIVE:
To examine the effect of human immunodeficiency virus (HIV)-1 infection on treatment outcome of laparoscopically verified acute salpingitis.
METHODS:
Women aged 18-40 years with laparoscopically verified acute salpingitis received antibiotic therapy that included cefotetan 2 g intravenously and doxycycline 100 mg orally every 12 hours and laparoscopically guided drainage of tuboovarian abscesses of 4 cm or more. Clinical investigators blinded to HIV-1 serostatus used predetermined clinical criteria, including calculation of a clinical severity score and a standard treatment protocol to assess response to therapy.
RESULTS:
Of the 140 women with laparoscopically confirmed acute salpingitis, 61 (44%) women had mild, 38 (27%) had moderate, and 41 (29%) had severe disease (ie, pyosalpinx, tuboovarian abscesses, or both). Fifty-three (38%) were HIV-1-infected. Severe disease was more common in HIV-1-infected in comparison with HIV-1-uninfected women (20 [38%] compared with 21 [24%], P = .02). Defined as time of hospital discharge or 75% or more reduction in baseline clinical severity score, HIV-1-infected women with severe (6 days [4-16] compared with 5 days [3-9], P = .09) but not those with either mild (4 days [2-6] compared with 4 days [2-6] P = .4) or moderate salpingitis (4 days [3-7] compared with 4 days [3-6] P = .32) tended to take longer to meet criteria for clinical improvement. The need for intravenous clindamycin or additional surgery was not different in HIV-1-infected and uninfected cases (15 [28%] compared with 18 [21%], P = .3).
CONCLUSION:
Although HIV-1 infection may prolong hospitalization in women with severe salpingitis, all women hospitalized with acute salpingitis responded promptly to antibiotic therapy and surgical drainage regardless of HIV-1 infection status.
URI
http://www.ncbi.nlm.nih.gov/pubmed/16582116http://erepository.uonbi.ac.ke:8080/xmlui/handle/123456789/17269
Citation
Obstet Gynecol.2006 Apr;107(4):807-12.Publisher
Department of Obstetrics and Gynecology, Kenyatta National Hospital, Nairobi, Kenya
Collections
- Faculty of Health Sciences (FHS) [10387]