two to three days, the patient is typically advised to seek further medical attention. Hospitalization sometimes becomes necessary if there are other complications. Treating sexual partners for possible STIs can help in treatment and prevention. For women with PID of mild to moderate severity, parenteral and oral therapies appear to be effective. It does not matter to their short- or long-term outcome whether antibiotics are administered to them as inpatients or outpatients. Typical regimens include cefoxitin or cefotetan plus doxycycline, and clindamycin plus gentamicin. An alternative parenteral regimen is ampicillin/sulbactam plus doxycycline. Erythromycin-based medications can also be used. A single study suggests superiority of azithromycin over doxycycline. Another alternative is to use a parenteral regimen with ceftriaxone or cefoxitin plus doxycycline. Clinical experience guides decisions regarding transition from parenteral to oral therapy, which usually can be initiated within 24–48 hours of clinical improvement. Prognosis Even when the PID infection is cured, effects of the infection may be permanent. This makes early identification essential. Treatment resulting in cure is very important in the prevention of damage to the reproductive system. Formation of scar tissue due to one or more episodes of PID can lead to tubal blockage, increasing the risk of the inability to get pregnant and long-term pelvic/abdominal pain. Certain occurrences such as a post pelvic operation, the period of time immediately after childbirth (postpartum), miscarriage or abortion increase the risk of acquiring another infection leading to PID. Epidemiology Globally about 106 million cases of chlamydia and 106 million cases of gonorrhea occurred in 2008. The number of cases of PID; however, is not clear. It is estimated to affect about 1.5 percent of young women yearly. In the United States PID is estimated to affect about one million people yearly. Rates are highest with teenagers and first time mothers. PID causes over 100,000 women to become infertile in the US each year. References External links CDC Unpacking PID: Mysterious Microbes, Diagnostic Dilemmas and Triple Treatments Webinar - 2013 Abdominal pain Sexually transmitted diseases and infections Bacterial diseases Chlamydia infections Infections with a predominantly sexual mode of transmission Wikipedia medicine articles ready to translate Inflammatory diseases of female pelvic organs Mycoplasma Gonorrhea