Smjernice u liječenju zdjelične upalne bolesti

master's thesis

• Title (english): Treatment guidelines for pelvic inflammatory disease
• Author: Zvonimir Glažar
• Mentor: Držislav Kalafatić (mentor)
• Committee member: Vladimir Banović (predsjednik povjerenstva)
• Committee member: Željko Duić (član povjerenstva)
• Committee member: Držislav Kalafatić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Gynecology and Obstetrics); Zagreb
• Defense date and country: 2020-07-17, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Gynecology and Obstetrics

Abstract

Zdjelična upalna bolest (eng. pelvic inflammatory disease - PID) upala je gornjeg dijela ženskog spolnog sustava, koja najčešće nastaje ascendentnim širenjem iz rodnice ili vrata maternice. Uzrok PID-a mogu biti brojni mikroorganizmi, a najčešći među njima su Chlamydia trachomatis i Neisseria gonorrhoeae. Iako upala može biti asimptomatska, tipična klinička slika uključuje bolove u donjem dijelu abdomena, osjetljivost adneksa pri fizikalnom pregledu te abnormalni vaginalni ili cervikalni iscjedak, dok laboratorijski nalazi mogu pokazati povišene sistemske upalne parametre. Temelj liječenja PID-a je antibiotska terapija koju često treba primijeniti empirijski, bez potvrde uzročnika upale, kako bi se spriječio nastanak dugoročnih posljedica PID-a, među kojima se ističu povećan rizik ektopične trudnoće i neplodnost. Aktualne europske i svjetske smjernice preporučuju nekoliko parenteralnih i oralnih antibiotskih terapijskih protokola za liječenje PID-a, ovisno o uzročnicima upale, težini kliničke slike i potrebe za hospitalizacijom. U najvećem broju slučajeva kao prva linija terapije preporučeni su cefalosporini u kombinaciji s doksiciklinom, uz mogući dodatak metronidazola. Osim tih lijekova, još nekoliko skupina antibiotika mogu se prema potrebi učinkovito koristiti za liječenje PID-a. Kako bi se na lokalnoj, ali i svjetskoj razini, smanjila incidencija PID-a, potrebno je preventivno djelovati boljom kontrolom i otkrivanjem spolno prenosivih infekcija koje su odgovorne za nastanak PID-a te općom edukacijom stanovništva o odgovornom spolnom ponašanju.

Abstract (english)

Pelvic inflammatory disease (PID) is the inflammation of the female upper reproductive tract that most commonly spreads from the vagina or cervix. Many pathogens are able to cause PID, with the most common being Chlamydia trachomatis and Neisseria gonorrhoeae. Even though the inflammation may be asymptomatic, the typical clinical presentation includes lower abdominal pain, adnexal tenderness upon physical examination and abnormal vaginal or cervical discharge, and laboratory findings may show elevated markers of systemic inflammation. The cornerstone of PID treatment is antibiotic therapy which often has to be administered empirically, without knowing the pathogen that caused the inflammation, to prevent the development of long-term sequelae of PID, most notably higher risk for ectopic pregnancy and infertility. Relevant world and European treatment guidelines recommend a variety of parenteral and oral antibiotic regimens for the treatment of PID, depending on the microbial cause of inflammation, severity of the disease and the potential need for hospital stay. As the first line of therapy the most commonly recommended antibiotics are cephalosporins in combination with doxycycline, with the possible addition of metronidazole. Besides those drugs, few other groups of antibiotics can be effectively used to treat PID. In order to lower the incidence of PID, both locally and globally, it is necessary to act preventively by better controlling and detecting sexually transmitted infections, and by educating the population on the responsible sexual behavior.

• Keywords: zdjelična upalna bolest; liječenje; smjernice
• Keywords (english): pelvic inflammatory disease; treatment; guidelines
• Language: croatian
• URN:NBN: urn:nbn:hr:105:873395
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2021-09-06 08:59:47