Subsequent sexually transmitted infection after outpatient treatment of pelvic inflammatory disease

Arch Pediatr Adolesc Med. 2008 Nov;162(11):1022-5. doi: 10.1001/archpedi.162.11.1022.

Abstract

Objective: To determine the frequency of recurrent sexually transmitted infections (STIs) and/or pelvic inflammatory disease (PID), the average time until subsequent infection following a baseline PID diagnosis, and age- and insurance-related associations with subsequent diagnoses.

Design: This study used prospective longitudinal follow-up of STI and/or PID outcome data from electronic medical records.

Setting: An urban academic hospital system.

Participants: A total of 110 adolescent girls treated for PID as outpatients in pediatric ambulatory sites. Main Exposure Electronic medical records used to assess subsequent PID diagnoses and/or infections with Neisseria gonorrhoeae or Chlamydia trachomatis during the study window.

Main outcome measures: Demographic, health care use, and STI and/or PID outcome data were examined. Incidence of an STI and/or PID was calculated as incident cases per person-months of exposure. Cox proportional hazard modeling was performed to evaluate the incidence of STI by age or insurance status.

Results: The mean (SD) age was 16.8 (1.9) years, 89% of patients were black, and 39% had laboratory results that were positive for N gonorrhoeae or C trachomatis at baseline. Thirty-four percent of patients had an additional diagnosis of an STI during the 48-month follow-up window (incidence, 3.1 per 100 person-months) and the mean (SD) time to a subsequent STI and/or PID was 377 (297) days. Of those patients, 67% (n = 18) had chlamydia, 11% had gonorrhoeae, and 44% had PID. There were no differences based on age or insurance status.

Conclusions: Adolescents treated for PID are at risk for subsequent STI and/or PID for a 48-month period. Given the need to prevent future infections in these vulnerable youths, efforts to explore the value of ongoing strategies for risk reduction after diagnosis are warranted.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Ambulatory Care*
  • Chlamydia Infections / drug therapy
  • Chlamydia Infections / epidemiology*
  • Chlamydia Infections / microbiology
  • Chlamydia trachomatis / isolation & purification
  • Demography
  • Female
  • Follow-Up Studies
  • Gonorrhea / drug therapy
  • Gonorrhea / epidemiology*
  • Gonorrhea / microbiology
  • Humans
  • Neisseria gonorrhoeae / isolation & purification
  • Pelvic Inflammatory Disease / drug therapy*
  • Pelvic Inflammatory Disease / epidemiology*
  • Prospective Studies
  • Recurrence
  • Sexually Transmitted Diseases / epidemiology*