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Study suggests federal guidelines for treating teen PID need clarification
Date:4/9/2013

A Johns Hopkins Children's Center survey of 102 clinicians who treat teenage girls with pelvic inflammatory disease (PID) has found that official guidelines designed to inform decisions about hospitalization versus outpatient care leave some clinicians scratching their heads.

The study, conducted by a team of adolescent medicine specialists and published online in the journal Sexually Transmitted Diseases, presented the clinicians with a series of common clinical scenarios and discovered a great deal of uncertainty among some trying to choose between inpatient and outpatient treatment for PID, a potentially damaging inflammation of the reproductive organs resulting from untreated, undertreated or recurrent sexually transmitted infections like chlamydia and gonorrhea, among others.

"The current guidelines from the Centers for Disease Control and Prevention leave a lot of room for interpretation and uncertainty, which can lead to considerable variability in treatment choice and outcomes from patient to patient," says study lead author Maria Trent, M.D., M.P.H., a pediatrician and teen health specialist at Johns Hopkins Children's Center.

Trent says that despite data showing that teens with PID often fail to adhere to outpatient treatment regimens and miss follow-up appointments, the CDC no longer recommends in-hospital treatment, although clinicians have the flexibility to hospitalize patients if they so choose.

However, the Johns Hopkins study findings suggest the guidelines fall short of informing that flexibility, particularly in cases that involve patients with recent abortions or whose social circumstances make it unlikely they would comply with the complex outpatient treatment, the researchers say. Such ambivalence was particularly common when the clinicians were uncertain about patients' ability to care for themselves, their willingness to take medications or about their willingness to share diagnoses with sex
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Contact: Ekaterina Pesheva
peshev1@jhmi.edu
410-502-9433
Johns Hopkins Medicine
Source:Eurekalert

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