A Randomized Controlled Trial Comparing the Treatment of Patients Tested for Chlamydia and Gonorrhea after a Rapid Polymerase Chain Reaction Test Versus Standard of Care Testing

Larissa S May, Chelsea E. Ware, Jeanne A. Jordan, Mark Zocchi, Catherine Zatorski, Yasser Ajabnoor, Jesse M. Pines

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background We tested the effect of a rapid molecular test for Chlamydia trachomatis (CT)/Neisseria gonorrhoeae (NG) diagnosis on clinical emergency department decision making compared with standard care. The new test presents an opportunity to improve antibiotic management and patient outcomes. Methods We conducted a randomized controlled trial of 70 consenting patients 18 years or older presenting to an urban emergency department with sexually transmitted infections complaints (vaginal/penile discharge, dysuria, vaginal/penile itching/pain, dyspareunia). Participants were randomized to rapid testing or standard care if a sexually transmitted infection was suspected. Follow-up phone calls were performed 7 to 10 days postdischarge. The primary outcomes included: antibiotic overtreatment rates, partner notification, and health care utilization. Results A total of 12.9% tested positive for CT or NG and received antibiotics. Test patients with negative results were less likely to receive empirical antibiotic treatment than control patients, absolute risk difference [RD], 33.4 (95% confidence interval [CI], 7.9%-58.9%), risk ratio [RR], 0.39 (95% CI, 0.19-0.82). Thirty-seven participants (53%) were contacted for follow-up 7 to 10 days postdischarge. Test patients were less likely to report missed antibiotic doses (RD, -51.3%; 95% CI, -84.4% to -18.2%; RR, 0.23; 95% CI, 0.06-0.88). Test patients were more likely to be notified of their results (RD, 50.6%; 95% CI, 22.7%-78.5%; RR, 2.72; 95% CI, 1.26-5.86). There were no significant differences in charges or health care utilization measures. Conclusions We found a significant reduction in unnecessary antibiotic treatment for CT/NG in subjects receiving the rapid molecular test compared with those receiving nucleic acid amplification test.

Original languageEnglish (US)
Pages (from-to)290-295
Number of pages6
JournalSexually Transmitted Diseases
Volume43
Issue number5
DOIs
StatePublished - May 1 2016

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Chlamydia
Gonorrhea
Standard of Care
Randomized Controlled Trials
Confidence Intervals
Anti-Bacterial Agents
Polymerase Chain Reaction
Neisseria gonorrhoeae
Chlamydia trachomatis
Patient Acceptance of Health Care
Odds Ratio
Sexually Transmitted Diseases
Hospital Emergency Service
Therapeutics
Nucleic Acid Amplification Techniques
Contact Tracing
Dyspareunia
Vaginal Discharge
Dysuria
Pruritus

ASJC Scopus subject areas

  • Dermatology
  • Public Health, Environmental and Occupational Health
  • Microbiology (medical)
  • Infectious Diseases

Cite this

A Randomized Controlled Trial Comparing the Treatment of Patients Tested for Chlamydia and Gonorrhea after a Rapid Polymerase Chain Reaction Test Versus Standard of Care Testing. / May, Larissa S; Ware, Chelsea E.; Jordan, Jeanne A.; Zocchi, Mark; Zatorski, Catherine; Ajabnoor, Yasser; Pines, Jesse M.

In: Sexually Transmitted Diseases, Vol. 43, No. 5, 01.05.2016, p. 290-295.

Research output: Contribution to journalArticle

May, Larissa S ; Ware, Chelsea E. ; Jordan, Jeanne A. ; Zocchi, Mark ; Zatorski, Catherine ; Ajabnoor, Yasser ; Pines, Jesse M. / A Randomized Controlled Trial Comparing the Treatment of Patients Tested for Chlamydia and Gonorrhea after a Rapid Polymerase Chain Reaction Test Versus Standard of Care Testing. In: Sexually Transmitted Diseases. 2016 ; Vol. 43, No. 5. pp. 290-295.
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