title: Status of adolescent pelvic inflammatory disease management in the United States.
abstract: OBJECTIVE
  Pelvic inflammatory disease (PID) is a common and serious reproductive health disorder and disease rates remain unacceptably high among adolescent girls and young adult women in the United States. Despite data demonstrating that women experience major adverse health outcomes after PID, national recommendations for management of adolescents have become increasingly less cautious in an era of cost-containment. In this review, we take an alternative look at published data on adolescents with PID to frame the next steps for optimizing management for this vulnerable population.
  
  
  RESULTS
  Several findings emerge from review of the literature. First, there is limited evidence to guide the best practice strategies for adolescents with PID due to low enrolment of early and middle adolescents in national trials. Second, adolescents and adult women in the United States receive suboptimal treatment regimens per Centers for Disease Control and Prevention (CDC) standards. Third, available evidence suggests that adolescents are at an increased risk for poor adherence to CDC recommendations for self-care, reacquisition of sexually transmitted infections (STIs) and PID, and subsequent adverse reproductive health outcomes.
  
  
  CONCLUSIONS
  Efforts to develop and integrate adolescent-focused, evidence-based strategies for PID management and prevention of subsequent STIs and recurrent PID are warranted.
authors.affiliation: aDepartment of Pediatrics, Johns Hopkins University School of Medicine bDepartment of Population, Family, & Reproductive Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
authors.forename: Maria
authors.initials: M
authors.lastname: Trent
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D016497:Adolescent Health Services; D000553:Ambulatory Care / Q000191:economics / Q000379:methods*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000453:epidemiology* / Q000517:prevention & control; D008403:Mass Screening / Q000191:economics / Q000379:methods*; D055118:Medication Adherence; D000292:Pelvic Inflammatory Disease / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000517:prevention & control; D017410:Practice Guidelines as Topic; D018570:Risk Assessment; D012648:Self Care; D012749:Sexually Transmitted Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000517:prevention & control; D014481:United States / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents
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