title: Cervicitis in adolescents: do clinicians understand diagnosis and treatment?
abstract: BACKGROUND
  Cervicitis is widespread, but no studies have examined cervicitis in accordance with established guidelines for diagnosis and treatment. Study objectives were to describe adherence to Centers for Disease Control and Prevention guidelines for diagnosis and treatment of cervicitis within an adolescent population and to compare factors associated with adherence to guidelines in a primary care setting and the Emergency Department.
  
  
  METHODS
  Data were collected as part of a retrospective chart review of evaluation, diagnosis, and treatment of STI in adolescent women in an outpatient setting. Participant charts were eligible for review if they were 12-21 years of age and were given an ICD-9 and chart diagnosis of cervicitis. Two primary outcome variables: meeting cervicitis guidelines and correct treatment among those meeting cervicitis guidelines (no/yes) were utilized; the study controlled for age, race, venue, past infection with chlamydia or gonorrhea.
  
  
  RESULTS
  Subjects (n = 365) were examined for the primary outcome variables and 75.1% (274/365) met at least one criterion for cervicitis. Of these, 166 (60.9%: 166/274) subjects were found to meet criteria for cervicitis alone, versus subjects meeting criteria for both cervicitis and pelvic inflammatory disease (PID) (39.4%: 108/274). The majority, 89.3%, (326/365) were treated for both chlamydia and gonorrhea, but only 64.7% (211/326) were treated correctly for both infections.
  
  
  CONCLUSIONS
  Our findings suggest that knowledge deficits exist in diagnosis and treatment of cervicitis in adolescent patients and in differentiating between cervicitis and PID. Educational tools, simulated patient exercises, and order sets may be warranted for quality improvement to allow for improved care of this at risk sexually active population.
authors.affiliation: Division of Adolescent Medicine, University of Arkansas for Medical Sciences, Arkansas, USA. woodsjenniferl@uams.edu
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Woods
authors.forename: Sarabeth L
authors.initials: SL
authors.lastname: Bailey
authors.forename: Devon J
authors.initials: DJ
authors.lastname: Hensel
authors.forename: Amy M
authors.initials: AM
authors.lastname: Scurlock
mesh_terms: D000293:Adolescent; D000328:Adult; D002690:Chlamydia Infections / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D003951:Diagnostic Errors / Q000706:statistics & numerical data; D004636:Emergency Service, Hospital / Q000592:standards / Q000706:statistics & numerical data*; D005260:Female; D006069:Gonorrhea / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006801:Humans; D008403:Mass Screening / Q000592:standards / Q000706:statistics & numerical data; D008508:Medication Errors / Q000706:statistics & numerical data; D000292:Pelvic Inflammatory Disease / Q000175:diagnosis / Q000188:drug therapy; D011320:Primary Health Care / Q000592:standards / Q000706:statistics & numerical data; D012189:Retrospective Studies; D002575:Uterine Cervicitis / Q000175:diagnosis* / Q000188:drug therapy* / Q000209:etiology; D055815:Young Adult