UK National Audit of chlamydial infection management in sexual health clinics. case notes audit: demography, diagnosis and treatment.
The case notes of cases of genital chlamydial infection were audited against the UK National Guideline. This was the first web-based and the largest national audit to date, with 193 clinics in all UK Regions contributing data. About half of all cases had no symptoms, with about one-third attending for routine or asymptomatic screens; suggesting significant provision of screening by clinics that might be managed differently to reduce workload. Nucleic acid amplification tests (NAATs) are now well established for chlamydial detection in UK clinics, with 93% of cases having genital NAATs. Azithromycin is now more commonly used than doxycycline (54% vs. 37%). Of 26 pregnant women, 20 were treated with azithromycin, suggesting that most prescribers treating pregnant women consider that erythromycin is not an adequate alternative to azithromycin. Most women had NAATs obtained from sites recommended by the Guideline, with 93% of women who had genital NAATs having these from the cervix or vulvovaginal area.
McClean
Hugo
H
Royal Society of Medicine, 1 Wimpole Street, London W1G 0AE, UK. Hugo.McClean@hullpct.nhs.uk
Carne
Chris
C
Bunting
Paul
P
Bhaduri
Sumit
S
Fernandes
Arnold
A
Dhar
Jyoti
J
Estreich
Steve
S
Daniels
David
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D000554:Ambulatory Care Facilities; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D017963:Azithromycin / Q000627:therapeutic use; D002690:Chlamydia Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D002692:Chlamydia trachomatis / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification*; D005260:Female; D052776:Female Urogenital Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D006801:Humans; D008297:Male; D052801:Male Urogenital Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D008485:Medical Audit; D008875:Middle Aged; D021141:Nucleic Acid Amplification Techniques; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D012749:Sexually Transmitted Diseases / Q000517:prevention & control*; D016896:Treatment Outcome; D006113:United Kingdom
D000900:Anti-Bacterial Agents; D017963:Azithromycin