Treatment of Pelvic Inflammatory Disease: Use Doxycycline With an Appropriate β-Lactam While We Wait for Better Data

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Abstract
Treatment of infertility is glamorous gynecology. Tubal microsurgery, embryo transfer, and in vitro fertilization are available only to women who can afford them. This multimillion-dollar high-technology medical industry is the impressive product of the science and practice of a growing body of specialists—membership in the American Fertility Society has increased from 5746 in 1976 to more than 10 000 in 1986. Treatment of pelvic inflammatory disease (PID), the most important preventable cause of infertility, afflicting an estimated 1 million American women yearly, is not glamorous gynecology. In this issue ofThe Journal, Grimes et al1document the sorry state of affairs for what must be one of the most neglected areas of American medicine. Their analysis of data from a national survey of office-based private physicians shows that from 1966 through 1983, most women with suspected PID were treated on an outpatient basis and most received a single drug.