|
PID is a condition that is not
terribly easy to diagnose because it looks like a number of other things. It looks like
acute appendicitis in some women, like hemorrhagic ovarian cyst, like endometriosis – a
lot of other things. A woman presents with pelvic discomfort. Upon gynecologic examination
she typically has tender ovaries and a tender uterus. Sometimes she has the kind of
discharge. There are a lot of different clinical manifestations that can be somewhat
difficult to diagnose. In the best clinical setting we test for STDs, and that can help us
to make the diagnosis, but you’d be amazed - as we’ve done our studies and looked at
records from around the country – how variable the treatment and the diagnostic workup
are for this condition. There are two strategies that we use: outpatient antibiotic
therapy and inpatient antibiotic therapy. Historically, there have always been some
doctors that have put a woman in the hospital and some doctors that have treated a woman
using antibiotics, and there hasn’t been a lot of rationale for that very remarkable and
cost-differential dichotomy. But we do know that somewhere between two hundred thousand
and three hundred thousand women a year are hospitalized, and a third of them have
abscesses and therefore, we feel, there’s no question they need to be hospitalized. They
need to have surgery in some cases and they certainly need transfused antibiotics. For the
other two thirds of these two hundred to three hundred thousand women, it’s really
unclear as to whether that makes sense. |