Presumptive and Follow-up Treatment for Gonorrhea and Chlamydia Among Patients Attending Public Health Department Clinics in Virginia, 2016

Overview

Journal Sex Transm Dis

Specialty Infectious Diseases

Date 2019 Feb 12

PMID 30742592

Citations 2

Authors

River A Pugsley

Thomas A Peterman

Affiliations

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Abstract

Background: Presumptive antibiotic treatment is common for suspected chlamydia (CT) and gonorrhea (GC) infections before laboratory confirmation to prevent complications, reduce loss-to-follow-up, and interrupt transmission. We assessed this practice in sexually transmitted disease (STD) and family planning clinics.

Methods: We performed a retrospective analysis of data from clinics in Virginia in 2016 using administrative data merged with electronic laboratory reporting data. After stratifying by patient and clinic characteristics, we calculated how often patients with positive CT/GC tests were treated presumptively or during a follow-up visit, and how many patients with negative tests were treated presumptively.

Results: Of 63,889 patient visits with valid laboratory results from 131 clinics, 13% tested positive for CT or GC. Overall, presumptive treatment was given to 45.2% of persons with positive tests and 10.1% of persons with negative tests. Among the 9443 patients presumptively treated, 40.7% had positive test results. Presumptive treatment was more common in STD clinics compared with family planning clinics (22% vs. 4%) and for males with positive tests compared to females (65% vs. 24%); smaller variations were observed across age, race/ethnicity, and diagnosis categories. Twenty-six percent of patients with positive tests who were not treated presumptively had no treatment recorded within 30 days.

Conclusions: Presumptive treatment for CT/GC was commonly used in this clinic population. It improved treatment coverage and reduced time to treatment, though some uninfected persons were treated. The impact of presumptive treatment on partner notification and treatment requires further study.

Citing Articles

Factors Associated With Delays in Presentation and Treatment of Gonorrhea, Massachusetts 2015-2019.

Elder H, Platt L, Leach D, Sheetoh C, Ramirez V, Molotnikov L Sex Transm Dis. 2023; 51(3):146-155.

PMID: 38133572 PMC: 10922616. DOI: 10.1097/OLQ.0000000000001917.

Adolescents Accessing School-Based versus Family Planning Clinics: Chlamydia and Gonorrhea Testing and Treatment Outcomes.

Raphael M, Abacan A, Smith P, Chacko M Biology (Basel). 2022; 11(4).

PMID: 35453720 PMC: 9027230. DOI: 10.3390/biology11040521.

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