title: Management of Pelvic Inflammatory Disease in Selected U.S. Sexually Transmitted Disease Clinics: Sexually Transmitted Disease Surveillance Network, January 2010-December 2011.
abstract: BACKGROUND
  Pelvic inflammatory disease (PID) remains an important source of preventable reproductive morbidity, but no recent studies have singularly focused on US sexually transmitted disease (STD) clinics in relationship to established guidelines for diagnosis and treatment.
  
  
  METHODS
  Of the 83,076 female patients seen in 14 STD clinics participating in the STD Surveillance Network, 1080 (1.3%) were diagnosed as having PID from 2010 to 2011. A random sample of 219 (20%) women were selected, and medical records were reviewed for clinical history, examination findings, treatment, and diagnostic testing. Our primary outcomes were to evaluate how well PID diagnosis and treatment practices in STD clinic settings follow the Centers for Disease Control and Prevention (CDC) treatment guidelines and to describe age group-specific rates of laboratory-confirmed Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) in patients clinically diagnosed as having PID in the last 12 months, inclusive of the PID visit.
  
  
  RESULTS
  Among the 219 women, 70.3% of the cases met the CDC treatment case definition for PID, 90.4% had testing for CT and GC on the PID visit, and 68.0% were treated with a CDC-recommended outpatient regimen. In the last 12 months, 95.4% were tested for CT or GC, and positivity for either organism was 43.9% in women aged 25 years or younger with PID, compared with 19.4% of women older than 25 years with PID.
  
  
  CONCLUSIONS
  Compliance with CDC guidelines was documented for many of the women with PID, though not all. Our findings underscore the need for continued efforts to optimize quality of care and adherence to current guidance for PID management given the anticipated expertise of providers in these settings.
authors.affiliation: From the *Surveillance and Data Management Branch, Division of STD Prevention (NCCHSTP), Centers for Disease Control and Prevention, Atlanta, GA; †San Francisco Department of Public Health, San Francisco, CA; ‡Public Health-Seattle and King County and Department of Medicine, University of Washington, Seattle, WA; §New York City Department of Health and Mental Hygiene, New York, NY; ¶University of Alabama at Birmingham, Birmingham, AL; and ∥Baltimore City Health Department and Johns Hopkins University School of Medicine, Baltimore, MD.
authors.forename: Eloisa
authors.initials: E
authors.lastname: Llata
authors.forename: Kyle T
authors.initials: KT
authors.lastname: Bernstein
authors.forename: Roxanne P
authors.initials: RP
authors.lastname: Kerani
authors.forename: Preeti
authors.initials: P
authors.lastname: Pathela
authors.forename: Jane R
authors.initials: JR
authors.lastname: Schwebke
authors.forename: Christina
authors.initials: C
authors.lastname: Schumacher
authors.forename: Mark
authors.initials: M
authors.lastname: Stenger
authors.forename: Hillard S
authors.initials: HS
authors.lastname: Weinstock
mesh_terms: D000293:Adolescent; D000328:Adult; D017963:Azithromycin / Q000008:administration & dosage; D002487:Centers for Disease Control and Prevention, U.S.; D002690:Chlamydia Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D042241:Early Diagnosis; D005260:Female; D005500:Follow-Up Studies; D006069:Gonorrhea / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D019983:Guideline Adherence; D006679:HIV Seropositivity / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D006801:Humans; D008795:Metronidazole / Q000008:administration & dosage; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D000292:Pelvic Inflammatory Disease / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D018571:Sentinel Surveillance; D014481:United States / Q000453:epidemiology
chemical_list: D008795:Metronidazole; D017963:Azithromycin