If an IUD is present, it should be removed after antibiotics have been started. Parenteral antibiotics may be switched to oral antibiotics 24 h after evidence of clinical improvement. All patients should be re-evaluated in 72 hours for evidence of substantial clinical improvement (defervescence, decreased abdominal tenderness, decreased uterine, adnexal, and cervical motion tenderness) and compliance with their regimen. 2°2.! and22 Patients who do not improve within this time frame should be re-evaluated for possible laparoscopic or surgical intervention, i.e., drainage of pus loculations or tubo-ovarian abscess, or to reconsider other possible diagnoses.
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