Article Text

  1. L Hwang1,
  2. K. Tebb1,
  3. M. Shafer1,
  4. C. Wibbelsman2,
  5. M. Pai-Dhungat1,
  6. R. Pantell1
  1. 1University of California, San Francisco, CA
  2. 2Kaiser Permanente


Purpose Age-specific rates of Chlamydia trachomatis (CT) remain highest among youth. Most CT control efforts focus on screening. However, little is known about the management of teens, especially follow-up retesting after the initial (+) CT. CDC Guidelines state that a “test of cure” is usually not necessary in uncomplicated infections, but retesting is recommended at 3-4 months and up to 1 year after treatment. The current study describes the management and timing of follow-up retesting of CT(+) teens by gender.

Methods A consecutive sample of teens 14-19 years testing CT (+) between 5/01-12/03 at 5 Northern California HMO pediatric clinics was identified using a centralized laboratory database. The first (+)CT result during study dates was defined as the index infection. Medical charts were reviewed for management, including antibiotic treatment and timing of retesting for CT within one year after treatment.

Results The sample consisted of 122 teens with a mean age 16.7 years (SD ± 1.1 yrs). Antibiotics were successfully prescribed for 118 (97%) teens. Safer sex counseling was provided for 96 (79%) teens. Providers advised partner notification and treatment in 63 (52%) cases. HIV and/or RPR screening was advised in 44 (36%) cases. (Table)

More males than females had no CT retesting at all during the 12 months post-index infection (77% vs. 51%, p=0.018).

Conclusions Most teens received appropriate antibiotics. In sharp contrast, much fewer received other follow-up care, with males faring more poorly than females with regard to retesting. Only 10% received CT retesting according to guidelines (i.e. from 3-12 months after treatment of index infection) and 22% were inappropriately retested within 3 weeks post-treatment (i.e. nonculture tests remain positive for up to 3 weeks post-treatment). The current study describes inappropriately timed retesting and highlights important “missed opportunities” to target this at-risk population with follow-up prevention interventions.

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