A Need for Standardization of the Diagnosis and Treatment of Pelvic Inflammatory Disease: Pilot Study in an Outpatient Clinic in Quito, Ecuador.
Adolescent
Adult
Ambulatory Care Facilities
/ statistics & numerical data
Anti-Bacterial Agents
/ therapeutic use
Cross-Sectional Studies
Ecuador
/ epidemiology
Electronic Health Records
Female
Humans
Middle Aged
Pelvic Inflammatory Disease
/ diagnosis
Pilot Projects
Reference Standards
Retrospective Studies
Risk Factors
Sexual Behavior
Ultrasonography
Young Adult
Journal
Infectious diseases in obstetrics and gynecology
ISSN: 1098-0997
Titre abrégé: Infect Dis Obstet Gynecol
Pays: Egypt
ID NLM: 9318481
Informations de publication
Date de publication:
2020
2020
Historique:
received:
27
08
2019
revised:
04
02
2020
accepted:
11
04
2020
entrez:
27
5
2020
pubmed:
27
5
2020
medline:
16
7
2021
Statut:
epublish
Résumé
Pelvic inflammatory disease (PID) diagnosis is often challenging as well as its treatment. This study sought to characterize the diagnostic and therapeutic trend among physicians at the outpatient level, in Quito, Ecuador, where currently no nationwide screening or specific clinical guideline has been implemented on PID or its main microbiological agents. A retrospective analysis of medical records with pelvic inflammatory disease diagnosis in an outpatient clinic was performed. Electronic medical records from 2013 to 2018 with any pelvic inflammatory disease-related diagnoses were retrieved. Information with regard to age, sexually related risk factors, symptoms and physical exam findings, ancillary tests, method of diagnosis, and antibiotic regimens was extracted. A total of 186 records were included. The most frequent clinical manifestations were vaginal discharge (47%) and pelvic pain (39%). In the physical examination, leucorrhea was the most frequent finding (47%), followed by lower abdominal tenderness (35%) and cervical motion tenderness in 51 patients (27%). A clinical diagnosis was established in 60% of patients, while 37% had a transvaginal sonography-guided diagnosis. Antibiotic treatment was prescribed with standard regimens in 3% of cases, while other regimens were used in 93% of patients. Additionally, an average of 1.9 drugs were prescribed per patient, with a range from 1 to 5, all in different combinations and dosages. No standardized methods of diagnosis or treatment were identifiable. These findings highlight the need for standardization of the diagnosis and treatment of PID attributed to chlamydial and gonococcal infections.
Sections du résumé
Background
Pelvic inflammatory disease (PID) diagnosis is often challenging as well as its treatment. This study sought to characterize the diagnostic and therapeutic trend among physicians at the outpatient level, in Quito, Ecuador, where currently no nationwide screening or specific clinical guideline has been implemented on PID or its main microbiological agents.
Methods
A retrospective analysis of medical records with pelvic inflammatory disease diagnosis in an outpatient clinic was performed. Electronic medical records from 2013 to 2018 with any pelvic inflammatory disease-related diagnoses were retrieved. Information with regard to age, sexually related risk factors, symptoms and physical exam findings, ancillary tests, method of diagnosis, and antibiotic regimens was extracted.
Results
A total of 186 records were included. The most frequent clinical manifestations were vaginal discharge (47%) and pelvic pain (39%). In the physical examination, leucorrhea was the most frequent finding (47%), followed by lower abdominal tenderness (35%) and cervical motion tenderness in 51 patients (27%). A clinical diagnosis was established in 60% of patients, while 37% had a transvaginal sonography-guided diagnosis. Antibiotic treatment was prescribed with standard regimens in 3% of cases, while other regimens were used in 93% of patients. Additionally, an average of 1.9 drugs were prescribed per patient, with a range from 1 to 5, all in different combinations and dosages.
Conclusions
No standardized methods of diagnosis or treatment were identifiable. These findings highlight the need for standardization of the diagnosis and treatment of PID attributed to chlamydial and gonococcal infections.
Identifiants
pubmed: 32454581
doi: 10.1155/2020/5423080
pmc: PMC7232719
doi:
Substances chimiques
Anti-Bacterial Agents
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
5423080Informations de copyright
Copyright © 2020 Francisco Cueva et al.
Déclaration de conflit d'intérêts
None of the authors declare any conflict of interest.
Références
Am J Obstet Gynecol. 2001 Apr;184(5):856-63; discussion 863-4
pubmed: 11303192
Gynecol Obstet Fertil Senol. 2019 May;47(5):404-408
pubmed: 30878687
N Engl J Med. 2015 May 21;372(21):2039-48
pubmed: 25992748
Infect Dis Clin North Am. 2013 Dec;27(4):793-809
pubmed: 24275271
Infect Dis Obstet Gynecol. 2002;10(4):171-80
pubmed: 12648310
MMWR Morb Mortal Wkly Rep. 2007 Apr 13;56(14):332-6
pubmed: 17431378
Int J STD AIDS. 2018 Feb;29(2):108-114
pubmed: 29198181
Infect Dis Obstet Gynecol. 2006;2006:30184
pubmed: 17485798
Cochrane Database Syst Rev. 2017 Apr 24;4:CD010285
pubmed: 28436019
BMJ Clin Evid. 2013 Dec 11;2013:
pubmed: 24330771
Infect Dis Obstet Gynecol. 2011;2011:753037
pubmed: 21822367
Epidemiology. 1994 Mar;5(2):234-42
pubmed: 8172999
J Emerg Med. 2009 Oct;37(3):257-63
pubmed: 18242922
Future Microbiol. 2010 Sep;5(9):1427-42
pubmed: 20860486
Expert Rev Anti Infect Ther. 2011 Jan;9(1):61-70
pubmed: 21171878
MMWR Recomm Rep. 2015 Jun 5;64(RR-03):1-137
pubmed: 26042815
Obstet Gynecol. 1996 May;87(5 Pt 1):730-6
pubmed: 8677076
MMWR Recomm Rep. 2014 Mar 14;63(RR-02):1-19
pubmed: 24622331
Sex Transm Dis. 2003 May;30(5):369-78
pubmed: 12916126
Sex Transm Infect. 2016 Sep;92(6):441-6
pubmed: 26825087