1) uterine or adnexal tenderness or
2) cervical motion tenderness and a PID diagnosis is considered for women with any pelvic tenderness and any signs of lower genital tract inflammation.
Additional diagnostic criteria to enhance the specificity include oral temperature greater than 101°F (38.3°C); abnormal cervical or vaginal mucopurulent discharge; white blood cells on saline microscopy of vaginal secretions; elevated erythrocyte sedimentation rate; elevated C-reactive protein; and laboratory documentation of cervical infection with N. gonorrhea or C. trachomatis.
If with an IUD, remove if less than three weeks after placement.
from the CDC Guidelines/NEJM 2015 review:
Outpatient regimen for mild-to-moderate pelvic inflammatory disease
Ceftriaxone 250 mg im single dose.
Cefoxitin 2 g im with probenicid 1 g po.
Inpatient regimen for moderate-to-severe pelvic inflammatory disease with or without tubo-ovarian abscess
One of the following:
Don't be creative. Follow the CDC guidelines. But. See below.
I would suggest that given 2019 susceptibilities and toxicities, clindamycin/gentamicin is so last century. Sure, it is state of the art. In 1992 (PubMed). As best I can tell, there are no studies of PID that use optimal, modern antibiotics and look at the most important long term outcome: fertility (PubMed).
Last Update: 07/20/19.