TOPLINE

Women with endometriosis who were hospitalized for pelvic inflammatory disease (PID) experienced more than double the rate of antibiotic treatment failure and nearly triple the recurrence rate compared to those without endometriosis.

METHODOLOGY

• Researchers conducted a retrospective cohort study at a tertiary care endometriosis center in Barcelona, Spain, analyzing data from 159 women hospitalized for PID between January 2018 and December 2023.
• A total of 48 women (30.2%) had endometriosis diagnosed by transvaginal ultrasound (TVUS), while 111 (69.8%) did not have the condition.
• Primary outcomes were antibiotic treatment failure, length of hospital stay, need for urgent surgery, and PID recurrence rate (defined as readmission ≥ 30 days post-discharge).

TAKEAWAY

• Women with endometriosis had significantly higher treatment failure rates (35.4% vs 17.1%, P = .01) and recurrence rates (31.3% vs 11.7%, P = .01) compared with those without endometriosis.
• Average hospital stay was significantly longer for patients with endometriosis (6.1 vs 3.9; P = .01).
• After adjusting for confounders, endometriosis was independently associated with a threefold increased risk for treatment failure (adjusted odds ratio [aOR], 3.0; P = .02) and recurrent PID (aOR, 3.0; P = .03).
• Vaginal and endocervical cultures were negative in 72.9% of endometriosis patients compared with 42.3%  in the non-endometriosis group.

IN PRACTICE

"Patients with endometriosis and PID are at increased risk of a more severe clinical course... Empirical antibiotic regimens may require modification to cover non-STD pathogens more effectively, and admission criteria should consider the likelihood of longer hospital stays," the authors wrote.

SOURCE

The study was led by Marta Camacho, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain. It was published online on July 19 in Acta Obstetricia et Gynecologica Scandinavica.

LIMITATIONS

The retrospective, single-center design may limit generalizability. Anaerobic cultures were not routinely performed, potentially underestimating their role in PID. Endometriosis diagnosis relied on TVUS rather than histological confirmation.

DISCLOSURES

The study received no specific funding. The authors reported no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.