What are appropriate antibiotics for PID?

Pelvic inflammatory disease (PID), refers to infection and inflammation of the female genital tract, including endometritis, salpingitis, tubo-ovarian abscess, and pelvic peritonitis.  PID is believed to be initiated by ascending infection from the vagina and cervix (often Chlamydia trachomatis), but is often polymicrobial.

The CDC recommends empiric treatment for PID in sexually active young women and other women at risk for STDs if no cause for symptoms can be found and the patient has at least one of the following:

1.  Cervical motion tenderness
OR
2.  Adnexal tenderness
OR
3.  Uterine tenderness

The following criteria enhance specificity and further support the diagnosis of PID:
1.  Temp > 101 F
2.  Abnormal mucopurulent cervical or vaginal discharge
3.  Presence of abundant leukocytes on wet prep
4.  Elevated ESR
5.  Elevated CRP
6.  Laboratory evidence of C. trachomatis or N. gonorrhea cervical infection

For patients with mild to moderate PID who can be managed as outpatients, the CDC recommends:

Patient who don't respond to oral therapy within 72 hours should be reevaluated both to confirm the diagnosis and to initiate parenteral therapy.

For patients with severe illness, tubo-ovarian abscess, pregnancy, or lack of response to oral agents, the CDC recommends inpatient therapy.  Recommended parenteral regimes include the following:

References:
1.  CDC Sexually Transmitted Disease Treatment Guidelines, 2010.  Available at http://www.cdc.gov/std/treatment/2010/STD-Treatment-2010-RR5912.pdf.  Accessed Feb. 9, 2012.