SANUM: Revista Científico-Sanitaria / Scientific-Health Journal
Published July 29, 2026 | Version v1
Journal article Open

OZONOTERAPIA COMO COADYUVANTE EN LA ENFERMEDAD INFLAMATORIA PÉLVICA AGUDA NO COMPLICADA

Authors/Creators

  • 1. MINSAP
  • 2. Hospital Dr. Joaquín Castillo Duany
  • 3. Hospital General Docente "Dr. Joaquín Castillo Duany". Santiago de Cuba, Cuba.
  • 4. Minsap
  • 5. ROR icon Centro Nacional de Información de Ciencias Médicas
  • 6. Hospital General Docente "Dr. Joaquín Castillo Duany". Santiago de Cuba, Cuba

Description

Tipo de artículo: Artículo original

Introducción: La enfermedad inflamatoria pélvica aguda no complicada representa un desafío terapéutico debido a las tasas de recurrencia y resistencia antimicrobiana. La ozonoterapia emerge como una alternativa coadyuvante por sus propiedades inmunomoduladoras y antimicrobianas.

Objetivo: Evaluar la eficacia de la ozonoterapia como tratamiento complementario en pacientes con enfermedad inflamatoria pélvica aguda no complicada, monitorizada mediante ecografía ginecológica y exudado vaginal. Periodo Enero-2024 y Junio-2025.

Método: se realizó un estudio analítico, longitudinal, cuasi experimental, con 80 pacientes divididas en grupo estudio (ozonoterapia + antimicrobianos, n=40) y grupo control (solo antimicrobianos, n=40). El esquema terapéutico consistió en Doxiciclina 100 mg cada 12 h por 14 días más Metronidazol 500 mg cada 12 h por 10 días. Se excluyeron mujeres con infección previa por Neisseria gonorrhoeae, absceso tubo‑ovárico ecográfico y se limitó el rango etario a 18‑45 años. Se evaluó la respuesta clínica, microbiológica y ecográfica.

Resultados: el grupo estudio mostró una efectividad del 95 % (38/40), significativamente superior al 77,5 % (31/40) del grupo control (p=0,023; RR 1,23; IC95 % 1,03–1,46). Las reacciones adversas gastrointestinales se presentaron exclusivamente en el grupo control (5 %).

Conclusión: La ozonoterapia adyuvante mejora significativamente la efectividad del tratamiento antibiótico convencional en enfermedad inflamatoria pélvica aguda no complicada, reduce complicaciones y presenta un perfil de seguridad favorable, sin reacciones adversas atribuibles.

Abstract (English)

Article type: Original Research Article

Introduction: Uncomplicated acute pelvic inflammatory disease (PID) poses a therapeutic challenge due to recurrence rates and antimicrobial resistance. Ozone therapy emerges as an adjuvant alternative due to its immunomodulatory and antimicrobial properties.

Objective: To evaluate the efficacy of ozone therapy as a complementary treatment in patients with uncomplicated acute PID, monitored by gynecological ultrasound and vaginal swab.

Method: Analytical, longitudinal, quasi‑experimental study with 80 patients divided into study group (ozone therapy + antimicrobials, n=40) and control group (antimicrobials alone, n=40). The therapeutic regimen consisted of doxycycline 100 mg every 12 hours for 14 days plus Metronidazole 500 mg every 12 hours for 10 days. Women with previous Neisseria gonorrhoeae infection, tubo‑ovarian abscess on ultrasound were excluded, and the age range was limited to 18‑45 years. Clinical, microbiological, and ultrasound responses were evaluated.

Results: The study group showed 95 % effectiveness (38/40), significantly higher than 77.5 % (31/40) in the control group (p=0.023; RR 1.23; 95 % CI 1.03–1.46). Gastrointestinal adverse reactions occurred only in the control group (5 %).

Conclusion: Adjuvant ozone therapy significantly improves the effectiveness of conventional antibiotic treatment in uncomplicated acute PID, reduces complications, and has a favorable safety profile with no attributable adverse reactions.

Files

sanum_v10_n3_a6.pdf

Files (391.4 kB)

Name Size Download all
md5:2f136dd9a43c281e16a1fa86bdfee2b4
391.4 kB Preview Download

Additional details

Additional titles

Translated title (English)
OZONE THERAPY AS AN ADJUVANT IN UNCOMPLICATED ACUTE PELVIC INFLAMMATORY DISEASE.

Dates

Collected
2026-04-16
manuscrito recibido
Accepted
2026-05-29
evaluación doble ciego
Available
2026-07-29
publicación en número de la revista

Software

Repository URL
https://revistacientificasanum.com/

References

  • 1. Brunham RC, Gottlieb SL, Paavonen J. Pelvic inflammatory disease. N Engl J Med. 2015. 372(21): 2039-48. https://10.1056/NEJMra1411426 2. Wiesenfeld HC, Meyn LA, Darville T, Macio IS, Hillier SL. A Randomized Controlled Trial of Ceftriaxone and Doxycycline, with or without Metronidazole, for the Treatment of Acute Pelvic Inflammatory Disease. Clin Infect Dis. 2021. 72(7): 1181-9. https://10.1093/cid/ciaa101 3. Savaris RF, Fuhrich DG, Duarte RV, Franik S, Ross J. Antibiotic therapy for pelvic inflammatory disease. Cochrane Database Syst Rev. 2017. 8(8): CD010285. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD010285.pub3/full 4. Kreisel KM, Llata E, Haderxhanaj L, et al. The burden of and trends in pelvic inflammatory disease in the United States, 2006-2016. Sex Transm Dis. 2021. 48(4): 254-60. https://10.1097/OLQ.0000000000001324 5. Sánchez-Pérez DB. et al. Comportamiento de la enfermedad inflamatoria pélvica aguda en la atención primaria de salud. Matanzas, 2017-2018. Rev Méd Electrón. 2022. 44(1). https://revmedicaelectronica.sld.cu/index.php/rme/article/view/4532 6. Lescalle Ortiz YC. et al. Factores clínico-epidemiológicos de la Enfermedad Inflamatoria Pelviana. Health Leadership Qual Life. 2024. 3: 510. https://10.56294/hl2024.510 7. Lescalle Ortiz YC. et al. Pelvic Inflammatory Disease: Impact, Diagnosis and Prevention. Health Leadership Qual Life. 2023. 2: 231. https://10.56294/hl2023231 8. Brenner E. et al. Reproductive Health in Young and Adolescent Females with Inflammatory Bowel Disease. Springer Nature Link. 2026. 28(8): 658-64. https://link.springer.com/article/10.1007/s11894-026-01032-7 9. Frock-Welnak D. et al. Identification and Treatment of Acute Pelvic Inflammatory Disease and Associated Sequelae. Obstetrics & Gynecology Clinics. 2021. 49(3): 551-579. https://www.obgyn.theclinics.com/article/S0889-8545(22)00031-6/abstract 10. Workowski KA, Bachmann LH, Chan PA, et al. Sexually Transmitted Infections Treatment Guidelines, 2021. MMWR Recomm Rep. 2021. 70(4): 1-187. https://www.cdc.gov/mmwr/volumes/70/rr/rr7004a1.htm 11. Unemo M, Lahra MM, Cole M, et al. World Health Organization Global Gonococcal Antimicrobial Surveillance Program (WHO GASP): review of new data and evidence to inform international collaborative actions. Lancet Microbe. 2019. 4(8): e627-e637. https://www.thelancet.com/journals/lanmic/article/PIIS2666-5247(23)00097-8/fulltext 12. Mitchell C, Prabhu M. Pelvic inflammatory disease: current concepts in pathogenesis, diagnosis and treatment. Infect Dis Clin North Am. 2013. 37(2): 245-59. https://10.1016/j.idc.2023.02.005 13. Bocci V. Ozone: a new medical drug. 2nd ed. Dordrecht: Springer; 2011. https://link.springer.com/book/10.1007/978-90-481-9234-2 14. Smith NL, Wilson AL, Gandhi J, et al. Ozone therapy: an overview of pharmacodynamics, current research, and clinical utility. Med Gas Res. 2017. 12(4): 117-24. https://10.4103/2045-9912.338745 15. Urgellés CS. et al. Uso de ozonoterapia en las pacientes con enfermedad inflamatoria pélvica aguda Etapa III. Revista Cubana de Obstetricia y Ginecología. 45(3). http://scielo.sld.cu/pdf/gin/v45n3/1561-3062-gin-45-03-e480.pdf 16. Mondéjar BM. Manejo de la candidiasis vaginal recurrente con ozonoterapia. Revista Cubana de Farmacia. 2022. 55(2):e783. https://www.medigraphic.com/pdfs/revcubfar/rcf-2022/rcf222j.pdf 17. Monif GRG. Infectious Diseases in Obstetrics and Gynecology. 2nd ed. Philadelphia: Harper & Row; 1983. 18. Shetty M. et al. Acute Pelvic Pain: Role of Imaging in the Diagnosis and Management. Seminars in Ultrasound, CT and MRI. 44(6); 491-500. https://www.sciencedirect.com/science/article/abs/pii/S0887217123000781 19. Clapés FM. Influencia de las enfermedades de transmisión sexual en mujeres con problemas de fertilidad. TRABAJO DE FIN DE GRADO. Universitat de les Illes Balears. 2023. https://repositori.uib.es/xmlui/handle/11201/170762 20. Loachamin PS. Relación entre los síntomas de infecciones del tracto genital y la función sexual en mujeres que acuden al consultorio obstétrico integral de la mujer, Quito 2022. Universidad de Cuenca. 2023 https://dspace.ucuenca.edu.ec/items/63a98737-a1e9-4999-839f-6aac75e87932 21. Sobel JD. Recurrent vulvovaginal candidiasis. N Engl J Med. 2021. 384(21): 2032-42. https://10.1056/NEJMra2028174 22. Bautista CT, Wurapa E, Sateren WB, et al. Bacterial vaginosis: a synthesis of the literature on etiology, prevalence, risk factors, and relationship with chlamydia and gonorrhea infections. Mil Med. 2016. 187(3-4): e402-e410. https://10.1093/milmed/usab278 23. Ross JDC, van der Linden P, De Sutter A, et al. European guideline for the management of pelvic inflammatory disease. Int J STD AIDS. 2018. 34(1): 2-12. https://10.1177/09564624221126906 24. Darville T. Pelvic inflammatory disease due to Chlamydia trachomatis: the role of the innate immune response. J Infect Dis. 2021. 224(12 Suppl 2): S39-S44. https://10.1093/infdis/jiaa591 25. Re L, Mawsouf MN, Menéndez S, et al. Ozone therapy: clinical and basic evidence of its therapeutic potential. Arch Med Res. 2008. 39(1): 17-26. https://10.1016/j.arcmed.2007.07.005 26. Sagai M, Bocci V. Mechanisms of action involved in ozone therapy: is healing induced via a mild oxidative stress? Med Gas Res. 2011; 1(1): 29. https://10.1186/2045-9912-1-29 27. Khairy H. et al. Vaginal Ozone Insufflation in the Treatment of Recurrent Candidal Vulvovaginitis: Randomized Control Trial. Evidence Based Women's Health Journal, 11(2). https://journals.ekb.eg/article_127920.html 28. World Federation of Ozone Therapy (WFOT). Madrid Declaration on Ozone Therapy. 3rd ed. Madrid: WFOT; 2020. URL: https://wfot.org/madrid-declaration 29. Bugg CW, Taira T, Zaurova M. Pelvic inflammatory disease: diagnosis and treatment in the emergency department. Emerg Med Pract. 2023; 25(3): 1-24. https://www.ebmedicine.net/topics/infectious-disease/pelvic-inflammatory-disease 30. Clavo B. et al. Long-Term Results with Adjuvant Ozone Therapy in the Management of Chronic Pelvic Pain Secondary to Cancer Treatment; 22(9). https://academic.oup.com/painmedicine/article/22/9/2138/6178593?guestAccessKey= 31. Clavo B. et al. Ozone Therapy in Refractory Pelvic Pain Syndromes Secondary to Cancer Treatment: A New Approach Warranting Exploration. Sage Journals Home. https://journals.sagepub.com/doi/abs/10.1089/jpm.2019.0597 32. Özgür AS. et al. Efficacy and safety of intravaginal gas ozone therapy in the treatment of bacterial vaginosis. https://dergipark.org.tr/en/pub/jhsm/article/1734344?issue_id=94685 33. Sayone CE. et al. Environmental sustainability in obstetrics and gynaecology: A systematic review. GJOB. 21. 2023. https://obgyn.onlinelibrary.wiley.com/doi/full/10.1111/1471-0528.17637 34. World Health Organization. Global health sector strategies on, respectively, HIV, viral hepatitis and sexually transmitted infections for the period 2022-2030. Geneva: WHO; 2022. https://www.who.int/publications/i/item/9789240053779