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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.