Faculty Collaboration Database

Gonorrhea and chlamydia in the emergency department: Continued need for more focused treatment for men, women and pregnant women. Am J Emerg Med 2017 May;35(5):701-703

Date

01/12/2017

Pubmed ID

28073612

DOI

10.1016/j.ajem.2017.01.002

Scopus ID

2-s2.0-85009289315 (requires institutional sign-in at Scopus site)   12 Citations

Abstract

INTRODUCTION: Delay in current nucleic acid amplification testing for Neisseria gonorrhoeae and Chlamydia trachomatis has led to recommendations for presumptive treatment in patients with concern for infection and unreliable follow-up. In the urban setting, it is assumed that many patients have unreliable follow-up, therefore presumptive therapy is thought to be used frequently. We sought to measure the frequency of disease and accuracy of presumptive treatment for these infections.

METHODS: This was an observational cohort study performed at an urban academic Level 1 trauma center ED with an annual census of 95,000 visits per year. Testing was performed using the APTIMA Unisex swab assay (Gen-Probe Incorporated, San Diego, CA). Presumptive therapy was defined as receiving treatment for both infections during the initial encounter without confirmation of diagnosis.

RESULTS: A total of 1162 patients enrolled. Infection was present in 26% of men, 14% of all women and 11% of pregnant women. Despite high frequency of presumptive treatment, >4% of infected patients in each category went untreated.

CONCLUSION: Inaccuracy of presumptive treatment was common for these sexually transmitted infections. There is an opportunity to improve diagnostic accuracy for treatment.

Author List

Wilson SP, Vohra T, Knych M, Goldberg J, Price C, Calo S, Mahan M, Miller J

Author

Mckenna Knych MD Assistant Professor in the Emergency Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Chlamydia Infections
Chlamydia trachomatis
Emergency Service, Hospital
Female
Follow-Up Studies
Gonorrhea
Health Services Research
Humans
Male
Needs Assessment
Neisseria gonorrhoeae
Nucleic Acid Amplification Techniques
Pregnancy
Pregnancy Complications, Infectious
Sensitivity and Specificity
United States
Urban Population