Which of the following parenteral treatment options for UTI is considered broad spectrum (G+, G-, anaerobes)?
a. Gentamicin, Tobramycin, Amikacin
b. Ampicillin-sulbactam, Piperacillin-tazobactam
c. Ceftriaxone, Ceftazidime, Cefepime
d. Imipenem-cilastatin, Meropenem, Doripenem, Ertapenem
They've been shown to correlate with the diagnosis of acute PID and that can be used to track response to therapy; however, further study is needed before they can be adopted into clinical practice. CA-125 is an antigen and it's known to be a tumor marker, and what it does is it measures the amount of protein cancer antigen 125 in the blood and it may be used to look for early signs of ovarian cancer and it seems to correlate with the severity of tubal inflammation when we're talking about PID. One of the problems with this, especially as a cancer antigen, is that it's not specific for cancer. In many other conditions such as PID can result in an increase in CA-125, but a lot of times when you look at things in combination, their strength as a biomarker increases such as the E-cadherin. The E stands for epithelial so it's a protein and loss of E-cadherin function has been observed in cancer progression metastases, so elevated E-cadherin has been observed in patients with PID, and it appears to be involved in the pathogenesis, so E-cadherin is a cell-cell adhesion molecule and epithelial integrity is compromised in PID so the way I think of it as E-cadherin being an adhesion molecule and you have epithelial integrity being damaged, increased friability of cells and this E-cadherin is most likely liberated from the cell surface or inside the cell and that's why it goes up.