Frank A Crespo1,2, Dervi Ganesh1, Kaming Lo1, Kevin Chin1, Paul Norris1, Nahida Chakhtoura1. 1. Department of Obstetrics & Gynecology, Jackson Memorial Hospital, University of Miami Miller School of Medicine, Miami, FL, USA. 2. Holtz Children's Hospital, Suite 3062, 1611 NW 12th Avenue, Miami, FL 33136, USA.
Abstract
OBJECTIVE: To compare surgical, ultrasound guided drainage, and medical management of tuboovarian abscesses (TOA) and determine if different characteristics in patient presentation influence treatment and outcome. METHODS: Retrospective cohort study of 158 patients admitted to Jackson Memorial Hospital between 2007 and 2012 with a TOA. RESULTS: Patients treated with IV antibiotics (IV) alone were hospitalized for 5.59 days (SD 2.52), IV antibiotics and US guided drainage (IV/US) were hospitalized for 9.63 days (SD 7.58), and IV antibiotics and surgery (IV/surgery) were hospitalized for 8.14 days ((SD3.9), (P < 0.001)). A total of 52 patients were readmitted with TOA; 41.8% were treated with IV; 26.9% were readmitted with IV/US; 7.1% were readmitted with IV/surgery (P < 0.022). Patients with a TOA measuring 0-8 cm were hospitalized for 5.97 days (SD 4.24), while those greater than 8 cm were hospitalized for 7.71 days ((SD 4.69), (P < 0.029)). Patients treated with a triple antibiotic regimen were hospitalized for 8.42 days (SD 5.70) versus 5.8 days (SD 3.24) when receiving an alternative regimen (P < 0.002). CONCLUSIONS: Longer hospitalization in patients treated uniformly with either triple antibiotics, ultrasound guided drainage, or surgery represents a delay in optimal treatment. Tailoring treatment plans based on patient presentation may allow for shorter hospital stays and improved morbidity.
OBJECTIVE: To compare surgical, ultrasound guided drainage, and medical management of tuboovarian abscesses (TOA) and determine if different characteristics in patient presentation influence treatment and outcome. METHODS: Retrospective cohort study of 158 patients admitted to Jackson Memorial Hospital between 2007 and 2012 with a TOA. RESULTS: Patients treated with IV antibiotics (IV) alone were hospitalized for 5.59 days (SD 2.52), IV antibiotics and US guided drainage (IV/US) were hospitalized for 9.63 days (SD 7.58), and IV antibiotics and surgery (IV/surgery) were hospitalized for 8.14 days ((SD3.9), (P < 0.001)). A total of 52 patients were readmitted with TOA; 41.8% were treated with IV; 26.9% were readmitted with IV/US; 7.1% were readmitted with IV/surgery (P < 0.022). Patients with a TOA measuring 0-8 cm were hospitalized for 5.97 days (SD 4.24), while those greater than 8 cm were hospitalized for 7.71 days ((SD 4.69), (P < 0.029)). Patients treated with a triple antibiotic regimen were hospitalized for 8.42 days (SD 5.70) versus 5.8 days (SD 3.24) when receiving an alternative regimen (P < 0.002). CONCLUSIONS: Longer hospitalization in patients treated uniformly with either triple antibiotics, ultrasound guided drainage, or surgery represents a delay in optimal treatment. Tailoring treatment plans based on patient presentation may allow for shorter hospital stays and improved morbidity.
Authors: M C Kamenga; K M De Cock; M E St Louis; C K Touré; S Zakaria; J M N'gbichi; P D Ghys; K K Holmes; D A Eschenbach; H D Gayle Journal: Am J Obstet Gynecol Date: 1995-03 Impact factor: 8.661
Authors: C R Cohen; S Sinei; M Reilly; E Bukusi; D Eschenbach; K K Holmes; J O Ndinya-Achola; J Bwayo; V Grieco; W Stamm; J Karanja; J Kreiss Journal: J Infect Dis Date: 1998-11 Impact factor: 5.226