Pelvic inflammatory disease in adolescents: care delivery in pediatric ambulatory settings.
OBJECTIVE
To evaluate care delivery patterns in patients treated for pelvic inflammatory disease in pediatric outpatient settings and to determine the effect of practice type on care delivery.


METHODS
Retrospective review of medical records for patients treated as outpatients in an urban academic pediatric facility. Care patterns were evaluated according to the Centers for Disease Control sexually transmitted disease guidelines.


METHODS
Fifty-six adolescent patients who were diagnosed with pelvic inflammatory disease in pediatric ambulatory settings between January 1, 2002, and December 31, 2002.


METHODS
Demographic information, documented patient history and examination, laboratory data, and discharge instructions.


RESULTS
Forty percent of patients were prescribed inadequate courses of medications. Patients who were seen in the pediatric emergency department were less likely to receive a standard medication regimen than those seen in the ambulatory setting. Most patients did not receive adequate instruction for self-care on review of written discharge instructions, and there were no differences based on location of care.


CONCLUSIONS
Many adolescents treated as outpatients for pelvic inflammatory disease may not receive adequate medications and instructions for self-care at discharge in pediatric ambulatory settings. This study suggests a need for aggressive quality improvement measures to enhance the care of adolescents with pelvic inflammatory disease in pediatric outpatient settings.
Trent
Maria
M
Pediatrics Department, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA. mtrent2@jhmi.edu
Ellen
Jonathan M
JM
Walker
Allen
A
D000046:Academic Medical Centers; D000293:Adolescent; D000553:Ambulatory Care / Q000379:methods* / Q000706:statistics & numerical data; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D017963:Azithromycin / Q000627:therapeutic use; D020682:Cefixime / Q000627:therapeutic use; D004318:Doxycycline / Q000627:therapeutic use; D017723:Drug Utilization Review; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007348:Insurance, Health / Q000706:statistics & numerical data; D008396:Maryland; D010043:Outcome and Process Assessment, Health Care; D010044:Outpatient Clinics, Hospital / Q000706:statistics & numerical data; D010351:Patient Discharge / Q000706:statistics & numerical data; D010353:Patient Education as Topic / Q000706:statistics & numerical data; D010372:Pediatrics / Q000379:methods* / Q000592:standards / Q000706:statistics & numerical data; D000292:Pelvic Inflammatory Disease / Q000209:etiology / Q000628:therapy*; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D012749:Sexually Transmitted Diseases / Q000150:complications / Q000188:drug therapy
D000900:Anti-Bacterial Agents; D017963:Azithromycin; D020682:Cefixime; D004318:Doxycycline