title: High frequencies of negative pretreatment results following presumptive antibiotic treatment for chlamydia and gonorrhea.
abstract: BACKGROUND
  The purpose of this study was to determine the frequencies of negative test results among all patients aged 18 years and older receiving presumptive antibiotic treatment for chlamydia and/or gonorrhea at the Sexually Transmitted Disease Clinic of the Palm Beach County Health Department. The treatment algorithms were based on guidelines of the Centers for Disease Control and Prevention.
  
  
  METHODS
  Clinic logs were retrospectively reviewed for a consecutive case series of all 1209 patients treated from November 1, 2007 to October 31, 2008. Urogenital specimens were collected and analyzed. Laboratory results were obtained from the Health Management System of the Palm Beach County Health Department.
  
  
  RESULTS
  Of the 1209 patients, 556 (46%) were treated for chlamydia, 30 (2.5%) for gonorrhea, and 623 (51.5%) for both. The frequencies of negative results were 68% for chlamydia or gonorrhea, 70.9% for chlamydia, 86.6% for gonorrhea, and 65.2% for chlamydia + gonorrhea.
  
  
  CONCLUSIONS
  These data indicate that implementation of the Centers for Disease Control and Prevention guidelines by the Sexually Transmitted Disease Clinic of the Palm Beach County Health Department results in presumptive treatment of more than two-thirds of patients with negative nucleic acid amplification test results for chlamydia, gonorrhea, or both. They also suggest the potential value of developing treatment algorithms to maximize treatment of patients with positive test results and minimize treatment of those with negative test results. One possible strategy to explore is the future utility of new testing and treatment methodologies in development.
authors: Palm Beach County Health Department, West Palm Beach, the Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida, USA.
authors: Belma
authors: B
authors: Andric
authors: Joanna
authors: J
authors: Drowos
authors: Mary Jo
authors: MJ
authors: Trepka
authors: Gabriel
authors: G
authors: Suciu
authors: Alina
authors: A
authors: Alonso
authors: Charles H
authors: CH
authors: Hennekens
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000465:Algorithms; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002690:Chlamydia Infections / Q000175:diagnosis / Q000188:drug therapy*; D005260:Female; D006069:Gonorrhea / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents