Abstract
Background
In the ED, patients are treated empirically for suspected gonorrhea and/or chlamydia
(GC). Limited studies have evaluated the treatment of sexually transmitted diseases
(STDs) in conjunction with predictor variables. This study will allow providers to
better identify patients with potential GC to streamline antibiotic treatment.
Objectives
The primary objective was to determine the incidence of positive assay in patients
that underwent GC screening. The secondary objectives included the proportion of patients
assayed that received empiric therapy and the predictive value of risk factors to
identify positive assays.
Methods
This retrospective cohort study included adult patients who presented to the health-system
EDs and underwent GC screening. Subjects were excluded if they were victims of sexual
assault, left AMA or eloped.
Results
A total of 490 assayed patients were included, of which 84 (17%) were found to be
positive for GC assay. Of the 278 patients treated empirically, 74% had a negative
assay. Of the entire sample (n = 490), risk factors found to predict a positive assay
(p < 0.05) included male, women <25 years of age, concomitant bacterial vaginosis,
pelvic inflammatory disease or trichomonas, penile discharge, inconsistent condom
use, previous/coexisting STDs, and uninsured.
Conclusions
Compared to previous reports, this study found a higher incidence of positive GC assays
for patients with suspected infection. This is the first study to evaluate GC testing
in both men and women in the ED, and risk factors not previously reported by the CDC
were identified.
Keywords
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Article Info
Publication History
Published online: August 07, 2018
Accepted:
August 7,
2018
Received in revised form:
July 26,
2018
Received:
June 4,
2018
Footnotes
☆Declaration of interest: none.
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
