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

Subsequent sexually transmitted infection after outpatient treatment of pelvic inflammatory disease.

Author information

1
Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA. mtrent2@jhmi.edu

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.

PMID:
18981349
DOI:
10.1001/archpedi.162.11.1022
[Indexed for MEDLINE]
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