Dosage Concerns for Pelvic Inflammatory Disease Medications - Obstetrics and Gynecology

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Dosage issues for pelvic inflammatory disease medications?


Hello, doctor.
I went to the gynecology clinic today due to hematuria, and the diagnosis was pelvic inflammatory disease.
The doctor prescribed Metronidazole to be taken three times a day, one tablet each time, and Curam to be taken twice a day, two tablets each time.
I'm concerned if this dosage is too strong because the pharmacist mentioned that both medications are potent, but Curam should only be taken one tablet at a time.
I'm hesitant to take too many tablets, fearing that the doctor might have made a mistake.
The doctor only has clinic hours once a week, and I won't be able to ask until my follow-up appointment on September 8.
Thank you for your help!

Ms. Chen, 30~39 year old female. Ask Date: 2020/09/02

Dr. Cai Yonglong reply Obstetrics and Gynecology


Curam is generally taken as one tablet in the morning and one in the evening, but the dosage can be increased in cases of severe infection.

Reply Date: 2020/09/02

More Info


When it comes to treating pelvic inflammatory disease (PID), the medications prescribed by your doctor, Metronidazole and Curam, are commonly used and effective. Understanding the dosage and potential concerns is crucial for ensuring safe and effective treatment.

Metronidazole is an antibiotic that is effective against a variety of anaerobic bacteria and certain parasites. It is often used to treat infections such as bacterial vaginosis and PID. The typical dosage for treating PID can vary, but a common regimen is 500 mg taken three times a day for 7 days. Your prescription of one tablet three times daily aligns with this standard treatment protocol, which is designed to ensure adequate drug levels in the body to effectively combat the infection.

Curam, on the other hand, is a combination antibiotic that contains amoxicillin and clavulanic acid. It is used to treat a range of infections, including those caused by bacteria that are resistant to other antibiotics. The usual dosage for adults can vary based on the severity of the infection, but it is often prescribed as 625 mg (which is typically two 312.5 mg tablets) taken twice daily. If your doctor prescribed two tablets twice a day, this is also within the standard dosing range for treating infections like PID.

Your concern about the strength of these medications is understandable, especially if the pharmacist mentioned that they are "strong." However, it's important to remember that the effectiveness of antibiotics is not solely determined by their strength but also by the appropriateness of their use for the specific infection being treated. The dosages prescribed by your doctor are based on clinical guidelines and your specific condition.

If you are worried about the dosages, here are a few points to consider:
1. Consult Your Doctor: If you have any doubts about the prescribed dosages, it is always best to consult your healthcare provider. They can clarify the rationale behind the dosages and address any concerns you may have.

2. Pharmacist's Role: Pharmacists are trained to provide information about medications, including potential side effects and interactions. If they express concerns about the dosage, it may be worth discussing this with your doctor for confirmation.

3. Adherence to Treatment: It is crucial to adhere to the prescribed treatment regimen to effectively clear the infection. Stopping or altering the dosage without consulting your doctor can lead to treatment failure and the development of antibiotic resistance.

4. Monitoring Side Effects: While taking these medications, monitor for any side effects. Common side effects of Metronidazole can include nausea, a metallic taste, and gastrointestinal upset. Curam may cause gastrointestinal disturbances as well. If you experience severe side effects or allergic reactions, seek medical attention promptly.

5. Follow-Up Appointments: Since your doctor has scheduled a follow-up appointment, it is essential to attend this visit to assess the effectiveness of the treatment and make any necessary adjustments.

In summary, the dosages of Metronidazole and Curam prescribed for your pelvic inflammatory disease appear to be within standard treatment guidelines. While it is natural to have concerns about medication strength, it is vital to trust your healthcare provider's expertise. If you have lingering doubts, do not hesitate to reach out to your doctor for clarification. Your health and safety are paramount, and open communication with your healthcare team is key to effective treatment.

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