Introduction: An ectopic pregnancy may be treated by methotrexate injection and/or surgery. Recent
research indicates that two doses of methotrexate is more effective at resolving an ectopic pregnancy
than a single dose.
Methods: We developed a protocol to allow patients to receive a second dose of methotrexate in the
infusion center as opposed to the emergency department. We then conducted a physician satisfaction
survey and retrospective data analysis.
Results: Time to resolution was not statistically significant between the one and two-dose groups.
However, a significant amount of time was saved by patients when a second dose of methotrexate was
given in the infusion center. Subsequently, physicians were more likely to prescribe two doses after
implementing the procedural change.
Discussion: Two-dose protocol for methotrexate may be considered in outpatient centers as it is more
time saving when compared to the ED for methotrexate injection.
