Adolescent girls and pelvic inflammatory disease: Experience and practices of emergency department pediatricians

Jacques Benaim, Mary Pulaski, Susan M. Coupey

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Objective: To describe the experience and practices of emergency department pediatricians in the United States related to the diagnosis and management of pelvic inflammatory disease (PID) in adolescent girls and to compare this experience with Centers for Disease Control and Prevention recommended management guidelines. Design: National telephone survey. Subjects: One hundred four pediatricians randomly selected from the 659 members of the Section on Emergency Medicine of the American Academy of Pediatrics. Response rate was 56%. Measures: A 42-item structured interview questionnaire assessed physician demographics, practice characteristics, PID diagnosis and management, and attitudes about sexually transmitted diseases in adolescents. Results: Fifty-one (94%) of 54 emergency department pediatricians had diagnosed PID in adolescents at least once within the past 2 years, and 35 (69%) had diagnosed PID, on average, once per month or more. Less than half the pediatricians (23/51 [45%]) routinely recommended hospital admission for adolescents with PID as suggested by the Centers for Disease Control and Prevention, and among those treating adolescents with PID as outpatients, just over half (20/37 [54%]) arranged close follow-up within 72 hours of initiating antibiotic treatment. Although most emergency department pediatricians routinely suggested condom use (47/54 [87%]) and human immunodeficiency virus testing (34/54 [63%]) after diagnosing a sexually transmitted disease, a minority routinely provided contraceptive counseling (23/54 [43%]) or written partner notification (17/54 [31%]). Approximately two thirds of pediatricians surveyed indicated that they thought that the care of an adolescent with a sexually transmitted disease should be different from that of an adult (35/54 [65%]) and that this age group was more prone to medical complications (38/54 [70%]). Conclusions: The results of this survey suggest that emergency department pediatricians frequently diagnose PID in adolescent girls and understand the high risk of medical complications in this age group, but their management is often less aggressive than that recommended by Centers for Disease Control and Prevention guidelines and sexually transmitted disease experts.

Original languageEnglish (US)
Pages (from-to)449-454
Number of pages6
JournalArchives of Pediatrics and Adolescent Medicine
Volume152
Issue number5
StatePublished - May 1998

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Pelvic Inflammatory Disease
Hospital Emergency Service
Sexually Transmitted Diseases
Centers for Disease Control and Prevention (U.S.)
Age Groups
Guidelines
Contact Tracing
Emergency Medicine
Condoms
Disease Management
Contraceptive Agents
Pediatricians
Telephone
Counseling
Outpatients
Demography
HIV
Interviews
Pediatrics
Anti-Bacterial Agents

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Adolescent girls and pelvic inflammatory disease : Experience and practices of emergency department pediatricians. / Benaim, Jacques; Pulaski, Mary; Coupey, Susan M.

In: Archives of Pediatrics and Adolescent Medicine, Vol. 152, No. 5, 05.1998, p. 449-454.

Research output: Contribution to journalArticle

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abstract = "Objective: To describe the experience and practices of emergency department pediatricians in the United States related to the diagnosis and management of pelvic inflammatory disease (PID) in adolescent girls and to compare this experience with Centers for Disease Control and Prevention recommended management guidelines. Design: National telephone survey. Subjects: One hundred four pediatricians randomly selected from the 659 members of the Section on Emergency Medicine of the American Academy of Pediatrics. Response rate was 56{\%}. Measures: A 42-item structured interview questionnaire assessed physician demographics, practice characteristics, PID diagnosis and management, and attitudes about sexually transmitted diseases in adolescents. Results: Fifty-one (94{\%}) of 54 emergency department pediatricians had diagnosed PID in adolescents at least once within the past 2 years, and 35 (69{\%}) had diagnosed PID, on average, once per month or more. Less than half the pediatricians (23/51 [45{\%}]) routinely recommended hospital admission for adolescents with PID as suggested by the Centers for Disease Control and Prevention, and among those treating adolescents with PID as outpatients, just over half (20/37 [54{\%}]) arranged close follow-up within 72 hours of initiating antibiotic treatment. Although most emergency department pediatricians routinely suggested condom use (47/54 [87{\%}]) and human immunodeficiency virus testing (34/54 [63{\%}]) after diagnosing a sexually transmitted disease, a minority routinely provided contraceptive counseling (23/54 [43{\%}]) or written partner notification (17/54 [31{\%}]). Approximately two thirds of pediatricians surveyed indicated that they thought that the care of an adolescent with a sexually transmitted disease should be different from that of an adult (35/54 [65{\%}]) and that this age group was more prone to medical complications (38/54 [70{\%}]). Conclusions: The results of this survey suggest that emergency department pediatricians frequently diagnose PID in adolescent girls and understand the high risk of medical complications in this age group, but their management is often less aggressive than that recommended by Centers for Disease Control and Prevention guidelines and sexually transmitted disease experts.",
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