Teens infrequently fill antibiotic prescriptions for STIs after ED discharge
ORLANDO, Fla. — Researchers said less than half of all teens diagnosed with sexually transmitted infections filled prescriptions for outpatient antibiotics when they were discharged from the ED. Teens who were admitted to the hospital, however, were approximately three times more likely to fill their prescriptions.
“According to the CDC, 15- to 24-year-olds account for half of the 20 million new STIs that occur year in the United States,” Monika Goyal, MD, MSCE, assistant division chief of emergency medicine, director of academic affairs and research, and assistant professor of pediatrics at Children’s National Health System, told Infectious Diseases in Children. “This new knowledge will inform future efforts to develop interventions to improve treatment adherence among youths diagnosed with STIs in the ED.”
Goyal and colleagues conducted a retrospective review of medical records of patients between the ages of 13 and 19 years who were treated at an urban pediatric ED and received an antibiotic prescription for the treatment of Chlamydia trachomatis (CT), Neisseria gonorrhea (GC), cervicitis or urethritis, or pelvic inflammatory disease (PID) in 2016. The researchers calculated the proportion of patients who filled their prescription after their ED visit.
The average age of the 337 adolescents diagnosed with an STI was 17.1 years, and 37.7% were given outpatient antibiotics for CT/GC (n = 42) or PID (n = 85). Nearly 90% of these patients were female, and most were non-Hispanic black (78.7%) and publicly insured (85%).
Of the patients diagnosed with PID, 18.1% were transferred to inpatient care for management. When outpatient antibiotics were prescribed, only 46.5% (95% CI, 37.7%-55.3%) of teens overall filled their prescription — 43.3% for CT/GC (95% CI, 31.2-55.4) and 50.5% for PID (95% CI, 39.8-61.4). Patients who were admitted after presenting to the ED were significantly more likely to fill prescriptions for STIs in an analysis that adjusted for age, race and ethnicity and insurance status compared with those who were discharged from the ED (aOR = 3.3; 95% CI, 1.2-8.7).
“The first step physicians need to take is to understand which barriers currently exist for prescription filling among adolescents,” Goyal said. – by Katherine Bortz
Lieberman A, et al. Frequency of prescription filling among adolescents prescribed treatment for STIs in the emergency department. Presented at: AAP National Conference & Exhibition; Nov. 2-6, 2018; Orlando, Fla.
Disclosure: Goyal reports no relevant financial disclosures.