Please use this identifier to cite or link to this item: https://dora.health.qld.gov.au/qldresearchjspui/handle/1/1618
Title: How accurate is presumptive Chlamydia trachomatis treatment? A 6-month clinical audit of a walk-in sexual health service
Authors: Jacups, Susan P
Potter, Caroline
Yarwood, Trent 
Doyle-Adams, Simon
Russell, Darren 
Issue Date: 2021
Source: Jacups SP, Potter C, Yarwood T, Doyle-Adams S, Russell D. How accurate is presumptive Chlamydia trachomatis treatment? A 6-month clinical audit of a walk-in sexual health service. Sex Health. 2021 Nov;18(5):413-420. doi: 10.1071/SH21078. PMID: 34742364.
Journal: Sexual health
Abstract: Background Chlamydia trachomatis (chlamydia) is highly prevalent and is an important sexually transmitted infection as it can lead to increased risk of HIV seroconversion; and if left untreated, can cause infertility in women. Clinical guidelines recommend treating chlamydia presumptively when presenting symptomatically; however, clinicians are now questioning this due to increasing prevalence of antimicrobial resistance. Methods To determine the accuracy of presumptive chlamydia treatment practices at a walk-in sexual health service in regional Australia, we audited all same-day screen and treat presentations prescribed azithromycin over a 6-month period in 2018. Results A total of 325 cases were included in the analysis. Over half (54%) the presentations returned negative pathology for all pathogens investigated. One quarter (25%) of presentations were positive for chlamydia, and (4%) reported a dual infection. A further one fifth (20%) were negative for chlamydia but positive for another pathogen. More symptomatic males than females returned positive pathology for chlamydia (8% vs 4%). Conclusions While presumptive treatment is recommended in the current guidelines, our findings indicate this resulted in over-treatment. Considering the increasing resistance patterns for Mycoplasma genitalium, which include azithromycin, presumptive treatments need to balance immediate client care needs against long-term community antimicrobial resistance outcomes. This internal audit provided a feedback mechanism to the walk-in sexual service, enabling modification of practices to provide more precise, individual clinical care within the bounds of current STI guidelines, while balancing wider the objectives of antimicrobial stewardship.
Description: Cairns & Hinterland Hospital and Health Service (CHHHS) affiliated authors: Caroline Potter, Trent Yarwood, Simon Doyle-Adams, Darren Russell.
DOI: 10.1071/SH21078
Keywords: adolescent;adult;chlamydia infections/epidemiology;microbial resistance;NAAT;PCR;reproductive health;sexually transmitted diseases/*epidemiology;youth
Type: Article
Appears in Sites:Cairns & Hinterland HHS Publications

Show full item record

Page view(s)

10
checked on Dec 10, 2022

Google ScholarTM

Check

Altmetric


Items in DORA are protected by copyright, with all rights reserved, unless otherwise indicated.