부산대학교 도서관

Background: In 2015, The Centers for Disease Control and Prevention (CDC) released updated Sexually Transmitted Diseases (STD) Treatment Guidelines. We sought to estimate adherence to the updated CDC-recommended treatment of chlamydia and gonorrhea using electronic health records (EHRs) in a public health clinic in Marion County, Indiana. Methods: A retrospective cohort study of deidentified EHR data for clients aged 15 to 60 years who had an index positive test result for chlamydia or gonorrhea between 2016 to 2020. A client was considered treated if the EHR possessed evidence of treatment within 30 days of the index positive test date. Medication and the doses prescribed were compared to CDC guidelines to determine if the client was given a recommended or alternative regimen. Results: Among 10,809 persons with index positive chlamydia test results and 6,749 persons with index positive gonorrhea test results, 90.2% and 85.8% had evidence of receipt of CDC-recommended treatment, respectively. Recommended treatment rates for chlamydia were highest (91.9%) in 2017 and lowest (87.0%) in 2020, with a median (p25 to p75) time to treatment of 9.0 (7 to 13) days. With respect to gonorrhea, recommended treatment was highest (86.4%) in 2020 and lowest (83.7%) in 2019, with a median (p25 to p75) time to treatment of 9.0 (7.0 to 14.0) days. Treatment rates for chlamydia were significantly higher among Hispanics (91.9%; 95% confidence interval [CI]: 90.3--93.4) compared to non-Hispanic whites (88.0%; 95% CI: 86.9--89.1). For chlamydia, treatment rates were lower among females (90.9%; 95% confidence interval [CI]: 90.0-- 91.8) compared to males (92.5%; 95% CI: 91.8--93.1). Treatment rates for gonorrhea were significantly lower among females (82.8%; 95% CI: 81.1--84.4) compared to males (88.6%; 95% CI: 87.6--89.5). treatment rates for gonorrhea were significantly lower among non-Hispanic whites (81.6%; 95% CI: 79.9-83.2) compared to non-Hispanic Blacks (88.7%; 95% CI: 87.7-89.7). Conclusion: Results suggest high levels of recommended treatment for chlamydia and gonorrhea at the public health clinic, indicating adherence to CDC recommended treatment guidelines. Although treatment rates are high, there is room for improvement to increase treatment rates among females to reduce complications. [ABSTRACT FROM AUTHOR]