Risk Factors for Ectopic Pregnancy-Reply

In Reply.—  I am pleased to respond to the comments by Dr Jones on my article in THE JOURNAL. It is important to emphasize that the presence of pathogenic microorganisms in the endocervix does not prove that such microbes are causally associated with upper genital tract infections. The study to which I referred reported the prevalence of Neisseria gonorrhoeae recovered from the fallopian tubes and peritoneal cavities of women with acute salpingitis.¹ Although nearly 50% of these patients had endocervical cultures that were positive for N gonorrhoeae, this organism was isolated from the fallopian tubes in only 23% of cases.I concur fully with the opinion of Dr Jones that broad-spectrum antibiotic therapy, including agents effective against gonococci, chlamydiae, and anaerobes, should be instituted promptly when the clinical or laparoscopic diagnosis of salpingitis is made. Indeed, this is the recommendation of the Centers for Disease Control.² Practitioners should