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Evaluation of Clinician-Reported Adherence to Centers for Disease
Control and Prevention Guidelines for the Treatment of Chlamydia trachomatis
in Two U.S. Health Plans.
Sexually Transmitted Diseases. 33(4):235-243.
Tun W, Stiffman M, Magid D, Lyons E, Irwin K.
Abstract
OBJECTIVE: The objective of this study was to assess clinician adherence to
Centers for Disease Control and Prevention-recommended treatments for Chlamydia
trachomatis (CT) in two health plans. STUDY DESIGN: Using hypothetical scenarios,
a 1999-2000 mail survey questioned clinicians about how they would treat
a cervicitis patient (CT and gonorrhea treatment recommended) and two patients
with laboratory-confirmed CT: an injection drug user (single-dose azithromycin
promotes adherence) and a pregnant patient (nonteratogenic drugs recommended).
RESULTS: Seven hundred forty-three (82%) of the 907 nonretired clinicians
receiving the survey completed it. Eighty-one percent (N=599) reported providing
recent CT care. Of these, 70.1% reported they would presumptively treat patients
with cervicitis for CT and gonorrhea, 17.1% for CT only, and 11.7% for neither
pathogen. Of the 580 clinicians addressing drug injectors, 61.7% reported
they would prescribe azithromycin. Most (88.8%) of the 343 clinicians seeing
pregnant patients reported they would prescribe Centers for Disease Control
and Prevention (CDC)-recommended antibiotics. Reported adherence varied by
clinician specialty and sources of treatment guidance. CONCLUSIONS: Most
clinicians reported treatment consistent with CDC guidelines.