Antibiotics for Pelvic Inflammatory Disease


Pelvic inflammatory disease (PID) is often caused by a combination of different types of bacteria, so a combination (regimen) of medicines is used to treat the infection. Treatment changes as new medicines are developed or as the bacteria that cause the infection become resistant to old medicines. The antibiotic used depends on the severity of the infection. These medicines may be taken orally, as an injection, or through a vein ( intravenous, or IV ). Some women need to be hospitalized for pelvic inflammatory disease treatment.

Generic Name Brand Name
doxycycline Vibramycin
metronidazole Flagyl

How It Works

Antibiotics kill the various bacteria that cause PID.

Why It Is Used

Antibiotics are used if you have one or more signs of PID and you are at risk for PID.

  • There is recent onset of lower pelvic tenderness or pain, especially if it is on both sides.
  • There is recent onset of pain or tenderness when the fallopian tubes or ovaries are touched or moved during examination.
  • There is pain or tenderness when the cervix is moved during examination.

Not all women who have PID will have pelvic pain. This is why many experts say that women should be treated for PID if they are at risk for PID and have pain when the cervix is moved, especially if there is an abnormal cervical discharge.

How Well It Works

Antibiotic treatment kills the bacteria causing PID. The risks of a future tubal pregnancy ( ectopic pregnancy ), ongoing (chronic) pelvic pain , and infertility are less if you start treatment early.

Side Effects

All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.

Here are some important things to think about:

  • Usually the benefits of the medicine are more important than any minor side effects.
  • Side effects may go away after you take the medicine for a while.
  • If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.

Call 911 or other emergency services right away if you have:

  • Trouble breathing.
  • Swelling of your face, lips, tongue, or throat.

Ceftriaxone or cefoxitin

Call your doctor right away if you have:

  • Hives.
  • Black or bloody stools.
  • Unusual bleeding or bruising.
  • Fever and chills.


Call your doctor right away if you have:

  • Hives.
  • Numbness, tingling, pain, or weakness in your hands or feet.

Common side effects of these medicines include:

  • Diarrhea.
  • Nausea or vomiting.
  • Headache.
  • Belly pain or cramps.
  • Dizziness.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About


Doxycycline can make your skin more sensitive to the sun.

  • Stay out of the sun, if possible.
  • Wear long pants, long-sleeved shirts, and hats, if possible.
  • Use sunscreen with a sun protection factor (SPF) that your doctor recommends.


Completely avoid alcohol use (including non-prescription nighttime cold medicines, such as NyQuil) when you are taking metronidazole. Combining alcohol with this medicine may cause severe nausea and vomiting.

Taking medicine

Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.

There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.

Advice for women

If you are pregnant, breast-feeding, or planning to get pregnant, do not use any medicines unless your doctor tells you to. Some medicines can harm your baby. This includes prescription and over-the-counter medicines, vitamins, herbs, and supplements. And make sure that all your doctors know that you are pregnant, breast-feeding, or planning to get pregnant.


Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

Complete the new medication information form (PDF) (What is a PDF document?) to help you understand this medication.


ByHealthwise Staff

Primary Medical Reviewer Kathleen Romito, MD - Family Medicine

Thomas M. Bailey, MD - Family Medicine

Specialist Medical Reviewer Sarah Marshall, MD - Family Medicine

Current as ofFebruary 20, 2015