Despite the controversy regarding the role of anaerobic bacteria and M. genitalium in the pathogenesis of acute PID, the polymicrobic nature of PID is widely acknowledged [1, 2]. As a consequence, PID is treated with antibiotics which provide coverage against a broad spectrum of potential pathogens. In 2010 the Center for Disease Control and Prevention updated their Guidelines for treatment of acute PID (Tables (Tables22 and and3).3). According to the CDC 2010 guidelines, PID treatment regimens must provide empiric, broad spectrum coverage of likely pathogens [1]. These guidelines recommend that all treatment regimens should be effective against N. gonorrhoeae and C. trachomatis even in the presence of negative endocervical screening for these organisms. Although the CDC notes that the need to eradicate anaerobes from women with PID has not been definitively determined, as reviewed above, they suggest that until regimens without adequate coverage for anaerobes have been shown to prevent long-term sequelae as successfully as those that include anaerobic coverage, coverage of anaerobes should be considered in the treatment of acute PID.