Ovary and Fallopian Tube Inflammation (Adnexitis): Drug Therapy

Therapeutic Targets

  • Improvement of the symptomatology
  • Elimination of pathogens
  • Avoidance of complications

Therapy recommendations

Therapy of acute adnexitis includes the administration of antibiotics and “antiphlogistic analgesics” (NSAID = nonsteroidal anti-inflammatory drugs, NSAID = nonsteroidal anti-inflammatory drugs).

The therapy of chronic adnexitis can be difficult if the symptoms are severe, because antibiotics and analgesics or anti-inflammatory drugs often do not alleviate the symptoms or do so only insufficiently. If these are due to severe adhesions (adhesions), surgery is occasionally necessary.

In acute adnexitis, local cold therapy is additively effective. In chronic adnexitis, local heat therapy is effective. See also “Further therapy”.

Therapy implementation

Antibiotic therapy for acute adnexitis may vary and is influenced by:

  • The regional resistance of the pathogens
  • The regional pathogen situation
  • the severity of the disease:
    • Oral therapy for mild and moderate disease.
      • Stage I: inflammation of the adnexa (appendage of the uterus, consisting of the ovary and fallopian tube) and possibly the pelvic peritoneum (pelvic peritoneum).
    • Intravenous/intramuscular (into the vein/muscle) therapy for severe disease:
      • Stage II: inflammatory conglomerate tumors (adhesions or adhesions of various organs or organ parts), abscesses (encapsulated accumulation of pus), clinical or sonographic (by ultrasound).
      • Stage III: Rupture (Latin ruptura ,rupture, breakthrough́; from rumpere ,reißeń, English rupture) of a tuboovarian abscess/abscess formation between the uterine tube (fallopian tube) and ovary/ovary).
    • Other indications for parenteral therapy are:
      • Surgical emergency can not be excluded
      • No response to oral therapy or intolerance of therapy.
      • Pregnancy
  • Antibiotics should cover a broad spectrum of pathogens (including chlamydia, gonococci, streptococci, staphylococci, mycoplasma, anaerobes, Escherichia coli, hemophylus influenzae); for infection with Mycoplasma genitalium: therapy with moxifloxacin.
  • Parenteral therapy should be given until 24 h after symptom relief, followed by oral therapy.
  • Duration of therapy is generally recommended for 10-14 days (optimal duration is not known).

Furthermore, non-steroidal anti-inflammatory drugs (NSAID; non steroidal anti- inflammatory drugs, NSAID) are used: Acetylsalicylic acid (ASA), ibuprofen or diclofenac. In cases of high gastrointestinal (GI) risk, combination with a proton pump inhibitor (acid blocker) or the use of selective COX-2 inhibitors is indicated.

Supplements (dietary supplements; vital substances)

Appropriate dietary supplements for natural defense should contain the following vital substances:

Note: The listed vital substances are not a substitute for drug therapy. Dietary supplements are intended to supplement the general diet in the particular life situation.