TY - JOUR
T1 - Presumptive and Follow-Up Treatment Associated with Gonorrhea and Chlamydia Testing Episodes in Sexually Transmitted Disease Clinics
T2 - Impact of Changing Treatment Guidelines for Gonorrhea, Sexually Transmitted Disease Surveillance Network, 2015-2018
AU - Llata, Eloisa
AU - Braxton, Jim
AU - Asbel, Lenore
AU - Huspeni, Dawn
AU - Tourdot, Laura
AU - Kerani, Roxanne P.
AU - Cohen, Stephanie
AU - Kohn, Robert
AU - Schumacher, Christina
AU - Toevs, Kim
AU - Torrone, Elizabeth
AU - Kreisel, Kristen
N1 - Funding Information:
Sources of Funding: This work was supported by the US Centers for Disease Control and Prevention through cooperative agreement number PS13-1306 (STD Surveillance Network).
Publisher Copyright:
© Lippincott Williams & Wilkins.
PY - 2023/1/1
Y1 - 2023/1/1
N2 - Background Centers for Disease Control and Prevention recommendation for treatment of uncomplicated gonorrhea (NG) were revised in December 2020 and include ceftriaxone monotherapy when chlamydial infection was excluded. We evaluated the impact of these revised treatment recommendations using data from a network of sexually transmitted disease (STD) clinics before the change in guidelines. Methods We performed a cross-sectional analysis from 8 STD clinics participating in the STD Surveillance Network from January 2015 to June 2018 assessing NG/chlamydia (CT) testing episodes, nucleic acid amplification test results, CT only and NG/CT treatment records, and timing of treatment. We describe the frequency of NG and CT treatment practices and what proportion of patients treated would not have had to receive an antichlamydial agent. Results Of 190,589 episodes that occurred during the study period, 67,895 (35.6%) episodes were associated with a treatment record consistent with NG or chlamydia (CT only [n = 37,530] or NG/CT [n = 30,365]), most (86%) were prescribed on the same-day as initial testing. Of the 67,895 episodes with corresponding treatment record(s), 42.1% were positive for either NG or CT compared with 3.7% were positive for NG or CT for those not associated with treatment records (n = 122,694 episodes). Among 30,365 episodes associated with NG/CT treatment records, monotherapy would only have been indicated for 10.1% (3081/30,365) of the episodes as they were treated on follow-up and were NG positive and CT negative. Conclusions Treatment was prescribed in one-third of NG/CT testing episodes, with the majority provided same day. Despite changes in NG treatment guidelines to ceftriaxone monotherapy, majority of patients would continue to receive an antichlamydia agent when treated for NG in these settings.
AB - Background Centers for Disease Control and Prevention recommendation for treatment of uncomplicated gonorrhea (NG) were revised in December 2020 and include ceftriaxone monotherapy when chlamydial infection was excluded. We evaluated the impact of these revised treatment recommendations using data from a network of sexually transmitted disease (STD) clinics before the change in guidelines. Methods We performed a cross-sectional analysis from 8 STD clinics participating in the STD Surveillance Network from January 2015 to June 2018 assessing NG/chlamydia (CT) testing episodes, nucleic acid amplification test results, CT only and NG/CT treatment records, and timing of treatment. We describe the frequency of NG and CT treatment practices and what proportion of patients treated would not have had to receive an antichlamydial agent. Results Of 190,589 episodes that occurred during the study period, 67,895 (35.6%) episodes were associated with a treatment record consistent with NG or chlamydia (CT only [n = 37,530] or NG/CT [n = 30,365]), most (86%) were prescribed on the same-day as initial testing. Of the 67,895 episodes with corresponding treatment record(s), 42.1% were positive for either NG or CT compared with 3.7% were positive for NG or CT for those not associated with treatment records (n = 122,694 episodes). Among 30,365 episodes associated with NG/CT treatment records, monotherapy would only have been indicated for 10.1% (3081/30,365) of the episodes as they were treated on follow-up and were NG positive and CT negative. Conclusions Treatment was prescribed in one-third of NG/CT testing episodes, with the majority provided same day. Despite changes in NG treatment guidelines to ceftriaxone monotherapy, majority of patients would continue to receive an antichlamydia agent when treated for NG in these settings.
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U2 - 10.1097/OLQ.0000000000001714
DO - 10.1097/OLQ.0000000000001714
M3 - Article
C2 - 36194764
AN - SCOPUS:85143645239
SN - 0148-5717
VL - 50
SP - 5
EP - 10
JO - Sexually transmitted diseases
JF - Sexually transmitted diseases
IS - 1
ER -