Pelvic Inflammatory Disease

Parenteral Treatment
Recommended Regimen

Ceftriaxone 1 g IV every 24 hours  

PLUS 

Doxycycline 100 mg orally or IV every 12 hours  

PLUS 

Metronidazole 500 mg orally or IV every 12 hours 

OR 

Cefotetan 2 g IV every 12 hours  

PLUS  

Doxycycline 100 mg orally or IV every 12 hours 

OR  

Cefoxitin 2 g IV every 6 hours 

PLUS  

Doxycycline 100 mg orally or IV every 12 hours 

Alternative Regimen

Ampicillin-sulbactam 3 g IV every 6 hours  

PLUS  

Doxycycline 100 mg orally or IV every 12 hours  

OR  

Clindamycin 900 mg IV every 8 hours  

PLUS  

Gentamicin loading dose IV or IM (2 mg/kg body weight), followed by a maintenance dose (1.5 mg/kg body weight) every 8 hours; single daily dosing (3–5 mg/kg body weight) can be substituted 

Intramuscular or Oral Treatment
Recommended Regimen

Ceftriaxone 500 mg* IM in a single dose  

PLUS  

Doxycycline 100 mg orally 2 times/day for 14 days with metronidazole 500 mg orally 2 times/day for 14 days  

OR 

Cefoxitin 2 g IM in a single dose and probenecid 1 g orally administered concurrently in a single dose  

PLUS  

Doxycycline 100 mg orally 2 times/day for 14 days with metronidazole 500 mg orally 2 times/day for 14 days 

OR  

Other parenteral third-generation cephalosporin (e.g., ceftizoxime or cefotaxime)  

PLUS 

Doxycycline 100 mg orally 2 times/day for 14 days with metronidazole 500 mg orally 2 times/day for 14 days 

* For persons weighing ≥150 kg, 1 g of ceftriaxone should be administered. 

Page last reviewed: July 16, 2021
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