Outpatient care called safe for teens with PID. (Review of 145 Patients).

PHILADELPHIA -- Outpatient treatment of pelvic inflammatory disease is safe for adolescent girls, even though almost a quarter of patients fail outpatient treatment and require hospitalization, based on a review of 145 patients at one hospital.

"Outpatient treatment of PID [pelvic inflammatory disease] in girls may save money because it resulted in shorter hospitalizations" when patients failed their initial treatment and required hospitalization, Dr. Paritosh Kaul said during the annual meeting of the North American Society for Pediatric and Adolescent Gynecology.

In addition, initial outpatient therapy seemed safe, because the girls who failed outpatient therapy were usually not more seriously ill at the time of their hospitalization, added Dr. Kaul, director of adolescent medicine at the Sandos Westside Family Health Center in Denver.

In 1998 the Centers for Disease Control and Prevention changed its guidelines for treating adolescent girls with PID. The CDC recommended that instead of routinely treating girls as inpatients, they should receive initial treatment as outpatients and be hospitalized only if outpatient treatment failed to resolve their infection.

The impact of this change was assessed by reviewing 145 girls with PID who were treated during 1995-2000 at the Children's Hospital at Montefiore in New York. The chart review included 54 girls treated during 1995-1997, before the CDC guidelines changed, and 91 girls who were treated during 1998-2000, after the new guidelines were in place. Their average age was 18.5 years, and the demographics and clinical parameters of the two groups were similar.

Patients were considered to fail their initial ...