Kane BG, Degutis LC, Sayward HK, et al. Compliance with the Centers for Disease Control and Prevention recommendations for the diagnosis and treatment of sexually transmitted diseases. Acad Emerg Med 2004; 11:371-377.

EDs are not adhering to recommended guidelines when caring for patients with sexually transmitted diseases (STDs), according to this study from Yale University School of Medicine in New Haven, CT.

Researchers conducted retrospective chart review of 203 patient visits for STDs, and compared documentation of the history, physical examination, diagnostic testing, prescribed antibiotics, and discharge instructions with current recommendations from the Centers for Disease Control and Prevention (CDC). Here are key findings:

  • All patients should have had gonorrheal and chlamydial cultures sent, but only about three-fourths of patients received this required testing.
  • Recommended antibiotic regimens for gonorrhea and chlamydia were correctly prescribed for less than one-third of patients.
  • Safe-sex instructions were documented for 50% of patients with urethritis, 18% of cervicitis patients, and 15% of patients with pelvic inflammatory disease.
  • Compliance with the recommended discharge instructions for pelvic inflammatory disease only was 3%.

"The study revealed that the overall compliance with the CDC recommendations for the diagnosis and treatment of STDs measured by documentation is extremely poor," wrote the researchers, who noted that the most concerning finding was failure to comply with the recommended antibiotics.

They recommended a formal feedback and practitioner accountability system, implementation of continuing quality improvement measures, and systems changes including computer-assisted decision support and automated data entry.