What follow-up care is recommended for patients treated for PID to ensure resolution of symptoms and prevent complications?

Follow-up care for patients treated for pelvic inflammatory disease (PID) includes:

• Review within 72 hours of starting antibiotic treatment to assess symptom resolution and treatment compliance; if symptoms persist or worsen, consider alternative diagnoses, adjust antibiotics, or arrange urgent hospital admission if needed.
• Arrange a further review 2–4 weeks after completion of antibiotic treatment to check compliance, symptom resolution, and ensure sexual partners have been screened and treated.
• Advise abstinence from all sexual activity until both the patient and any sexual partners have completed treatment, are symptom-free, and have had a test of cure if clinically indicated.
• Arrange repeat testing 3–5 weeks after treatment completion if symptoms persist, compliance is uncertain, or there is suspicion of reinfection or antibiotic resistance; specifically, repeat testing is recommended 2–4 weeks after treatment for gonorrhoea and 4 weeks for Mycoplasma genitalium infections.
• Advise the use of barrier contraception methods to reduce the risk of reinfection and protect against other sexually transmitted infections (STIs).
• Ensure sexual partners from the last 6 months attend specialist sexual health services for screening, treatment, and contact tracing; if partners are unable or unwilling to attend, offer empirical antibiotic treatment and screening as appropriate.
• Consider pregnancy testing and emergency contraception if an intrauterine device (IUD) is removed during treatment.

These measures help ensure resolution of symptoms, prevent complications such as tubo-ovarian abscess or pelvic peritonitis, and reduce the risk of reinfection and long-term sequelae.

References: NICE CKS