Teens and young adults have the highest rates of sexually transmitted infections (STIs)
of any age group [
[1]
]. Emergency departments (EDs) are a key point of access to care for many of these
patients. When adolescents present with symptoms suggestive of an STI, the Centers
for Disease Control and Prevention (CDC) recommends routine testing for Neisseria gonorrhoeae (GC) and Chlamydia trachomatis (CT), liberal antibiotic treatment, and close outpatient follow-up [
[1]
]. Previous studies have shown the CDC's suggestions are not always put into action,
and there are no specific guidelines for ED providers [
2
,
3
,
4
,
5
]. The unpredictable diagnostic and treatment patterns of practitioners can lead to
underrecognized GC and CT infections, delay in treatment for patients, and lingering
consequences of the STI infection itself. This study sought to quantify the frequency
of these missed GC and CT cervical infections in adolescent females tested in the
ED, to describe and compare the characteristics of those treated and not treated during
their initial presentation, and to characterize the influence of ED provider type
and gender on the empiric treatment of STIs.Keywords
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References
- Centers for disease control and prevention. Sexually transmitted diseases treatment guidelines, 2015.MMWR Recomm Rep. 2015; 64: 1-137
- Empiric treatment of gonorrhea and chlamydia in the ED.Am J Emerg Med. 2001; 19: 274-275
- Factors associated with the over-treatment and under-treatment of gonorrhea and chlamydia in adolescents presenting to a public hospital emergency department.Int J Infect Dis. 2016; 53: 34-38
- Adolescent patients with sexually transmitted infections: who gets lost to follow-up?.J Emerg Med. 2014; 47: 507-512
- Sensitivity and specificity of empiric treatment for sexually transmitted infections in a pediatric emergency department.J Pediatr. 2017; 189: 48-53
- Chlamydia and gonorrhea screening in United States emergency departments.J Emerg Med. 2013; 44: 558-567
Article Info
Publication History
Published online: March 02, 2018
Accepted:
March 2,
2018
Received in revised form:
February 27,
2018
Received:
February 7,
2018
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
