Laboratory-confirmed gonorrhea and/or chlamydia rates in clinically diagnosed pelvic inflammatory disease and cervicitis

Identifying a need for more focused treatment of chlamydia and gonorrhoea in the emergency department

“…Though a discussion about antimicrobial stewardship would not be complete without acknowledging the potential morbidity associated with missed treatment, which most notably includes pelvic inflammatory disease, ectopic pregnancy and infertility. 1,2 Also interesting, despite our study observing a potentially lower rate of presumptive treatment when compared to prior studies, [9][10][11][12][13][14][15] we observed a substantially lower miss rate than a more recent study by Schechter-Perkins et al, where they report initial miss rate as high as 46%. 16 Though Schechter-Perkins et al were able to confirm 31% subsequently underwent treatment during follow-up, 15% were ultimately never confirmed to receive treatment.…”

“…This notion is challenged by our observation where almost two-thirds of women and nearly a quarter of men being tested were not presumptively treated. [9][10][11][12][13][14][15] However, there remained a significant rate of missed treatment, likely in part due to this lower rate of presumptive therapy. Another cause for missed treatment may have been result of a subset of patients being diagnosed with a new pregnancy, which has previously been demonstrated to be a population at increased risk for missing necessary treatment.…”

“…7,8 Patients seen in the urban ED often have an increased risk and difficulty with followup; therefore, presumptive therapy for most patients with a concern for STI is thought to be a common practice in this setting. [9][10][11] The primary aim was to determine the proportion of women and men tested for CT and GC whom accurately received presumptive antimicrobial treatment on their initial ED encounter.…”

Characteristics of pelvic inflammatory disease where no sexually transmitted infection is identified: a cross-sectional analysis of routinely collected sexual health clinic data

“…In the USA, 17% of emergency department PID had chlamydia and/or gonorrhoea3 and 23% of PID in an inpatient/outpatient treatment trial had chlamydia, gonorrhoea and/or MG 4. In the UK, a case–control study found no aetiological agent in 64% PID 5.…”

Population attributable fraction of pelvic inflammatory disease associated with chlamydia and gonorrhoea: a cross-sectional analysis of Australian sexual health clinic data

“…More recently, nuclear acid amplification tests have detected these infections in 17% PID cases 4. Largely affecting young heterosexuals, chlamydia is the most commonly diagnosed bacterial STI throughout the developed world with all age rates per 100 000 of 359 in Australia,5 447 in the USA6 and 386 in the UK 7.…”