Evaluation of clinician-reported adherence to Centers for Disease Control and Prevention guidelines for the treatment of Chlamydia trachomatis in two U.S. health plans.
OBJECTIVE
The objective of this study was to assess clinician adherence to Centers for Disease Control and Prevention-recommended treatments for Chlamydia trachomatis (CT) in two health plans.


METHODS
Using hypothetical scenarios, a 1999-2000 mail survey questioned clinicians about how they would treat a cervicitis patient (CT and gonorrhea treatment recommended) and two patients with laboratory-confirmed CT: an injection drug user (single-dose azithromycin promotes adherence) and a pregnant patient (nonteratogenic drugs recommended).


RESULTS
Seven hundred forty-three (82%) of the 907 nonretired clinicians receiving the survey completed it. Eighty-one percent (N=599) reported providing recent CT care. Of these, 70.1% reported they would presumptively treat patients with cervicitis for CT and gonorrhea, 17.1% for CT only, and 11.7% for neither pathogen. Of the 580 clinicians addressing drug injectors, 61.7% reported they would prescribe azithromycin. Most (88.8%) of the 343 clinicians seeing pregnant patients reported they would prescribe Centers for Disease Control and Prevention (CDC)-recommended antibiotics. Reported adherence varied by clinician specialty and sources of treatment guidance.


CONCLUSIONS
Most clinicians reported treatment consistent with CDC guidelines.
Tun
Waimar
W
Centers for Disease Control and Prevention, Division of STD Prevention, Atlanta, Georgia, USA. wtun@fhi.org
Stiffman
Michael
M
Magid
David
D
Lyons
Ella
E
Irwin
Kathleen
K
D002487:Centers for Disease Control and Prevention, U.S.; D002690:Chlamydia Infections / Q000517:prevention & control*; D002692:Chlamydia trachomatis; D003120:Colorado; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006279:Health Maintenance Organizations; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000517:prevention & control; D015819:Substance Abuse, Intravenous; D011795:Surveys and Questionnaires; D014481:United States; D002575:Uterine Cervicitis / Q000382:microbiology / Q000628:therapy*