{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T00:52:01Z","timestamp":1774227121868,"version":"3.50.1"},"reference-count":33,"publisher":"CSIRO Publishing","issue":"2","license":[{"start":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T00:00:00Z","timestamp":1771459200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/doi.org\/10.1071\/journalslicense"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Clinical diagnoses of cervicitis and pelvic inflammatory disease (PID) are often subjective, and not all are associated with sexually transmitted infections (STI). Presumptive treatment for these syndromes may lead to unnecessary antibiotics in those subsequently found to be STI-negative. We investigated patient and clinician characteristics associated with accurately diagnosing bacterial STI-positive cervicitis and PID. We quantified the amount of unnecessary antibiotics prescribed in STI-negative cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross-sectional study of 243 cervicitis and 179 PID patients presenting to Sydney Sexual Health Centre between January 2020 and 2023 was conducted. Patient demographics, sexual behaviours, symptoms, examination, results and clinician type were extracted from electronic medical records.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 70 cervicitis (28.8%) and 28 PID (15.6%) patients were bacterial-STI positive. Age\u00a0&amp;lt;25\u00a0years (aOR 2.78, 95% CI 1.25\u20136.25, P\u00a0&amp;lt;\u00a00.001) was associated with bacterial STI-positive cervicitis; presence of endocervical mucopurulent discharge on examination (aOR 6.05, 95% CI 2.20\u201316.68, P\u00a0&amp;lt;\u00a00.001) and current use of contraception (aOR 7.69, 95% CI 2.13\u201325.00, P\u00a0=\u00a00.002) were associated with bacterial STI-positive PID. For cervicitis, there were 139 doxycycline, 11 azithromycin and 5 ceftriaxone courses that were given to STI-negative patients. For PID, there were 148 doxycycline, 7 azithromycin and 152 ceftriaxone courses that were given to STI-negative patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study identified several characteristics that predicted STI-positive cervicitis and PID. However, none predicted STI-positivity with high degrees of confidence. Presumptive treatment leads to significant unnecessary antibiotic use, but ceftriaxone may have additional coverage beyond gonorrhoea. Rapid molecular point-of-care testing should be trialled to reduce unnecessary antibiotics for these syndromes \u2013 starting with cervicitis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1071\/sh25221","type":"journal-article","created":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T00:06:16Z","timestamp":1774224376000},"source":"Crossref","is-referenced-by-count":0,"title":["Factors predicting STI-positive cervicitis and pelvic inflammatory disease, and implications on antibiotic use: a cross-sectional analysis"],"prefix":"10.1071","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-1758-5774","authenticated-orcid":true,"given":"Shreya","family":"Chawla","sequence":"first","affiliation":[{"name":"AFaculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia."},{"name":"BSydney Sexual Health Centre, Sexual Health and Bloodborne Viruses Services, South Eastern Sydney Local Health District, Camperdown, NSW, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0402-0506","authenticated-orcid":true,"given":"Rick","family":"Varma","sequence":"additional","affiliation":[{"name":"BSydney Sexual Health Centre, Sexual Health and Bloodborne Viruses Services, South Eastern Sydney Local Health District, Camperdown, NSW, Australia."},{"name":"CThe Kirby Institute, UNSW Sydney, Sydney, NSW, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arthur Ka Chun","family":"Wong","sequence":"additional","affiliation":[{"name":"BSydney Sexual Health Centre, Sexual Health and Bloodborne Viruses Services, South Eastern Sydney Local Health District, Camperdown, NSW, Australia."},{"name":"CThe Kirby Institute, UNSW Sydney, Sydney, NSW, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"67","published-online":{"date-parts":[[2026,3,23]]},"reference":[{"key":"2026032220061209400_R1","unstructured":"World Health Organization (WHO). Sexually transmitted infections (STIs). WHO; 2023."},{"issue":"2","key":"2026032220061209400_R2","doi-asserted-by":"publisher","first-page":"e371","DOI":"10.1093\/cid\/ciae295","article-title":"Systematic review and meta-analysis of the association between Mycoplasma genitalium and pelvic inflammatory disease (PID).","volume":"28","author":"Htaik","year":"2024","journal-title":"Clin Infect Dis"},{"issue":"9","key":"2026032220061209400_R3","doi-asserted-by":"publisher","first-page":"1517","DOI":"10.1093\/cid\/ciz429","article-title":"Chlamydia trachomatis and the risk of pelvic inflammatory disease, ectopic pregnancy, and female infertility: a retrospective cohort study among primary care patients.","volume":"69","author":"Den Heijer","year":"2019","journal-title":"Clin Infect Dis"},{"issue":"7","key":"2026032220061209400_R4","doi-asserted-by":"publisher","first-page":"534","DOI":"10.1136\/sextrans-2017-053423","article-title":"Rates of pelvic inflammatory disease and ectopic pregnancy in Australia, 2009\u20132014: ecological analysis of hospital data.","volume":"94","author":"Goller","year":"2018","journal-title":"Sex Transm Infect"},{"issue":"1","key":"2026032220061209400_R5","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1056\/NEJM198407053110101","article-title":"Mucopurulent cervicitis--the ignored counterpart in women of urethritis in men.","volume":"311","author":"Brunham","year":"1984","journal-title":"N Engl J Med"},{"key":"2026032220061209400_R6","unstructured":"Centers for Disease Control and Prevention. Sexually transmitted infections treatment guidelines, 2021: diseases characterized by urethritis and cervicitis. 2021. Available at https:\/\/www.cdc.gov\/std\/treatment-guidelines\/urethritis-and-cervicitis.htm."},{"issue":"3","key":"2026032220061209400_R7","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1136\/sextrans-2015-052332","article-title":"Cervicitis aetiology and case definition: a study in Australian women attending sexually transmitted infection clinics.","volume":"92","author":"Lusk","year":"2016","journal-title":"Sex Transm Infect"},{"issue":"5","key":"2026032220061209400_R8","doi-asserted-by":"publisher","first-page":"379","DOI":"10.1097\/OLQ.0b013e31828bfcb1","article-title":"Prevalence and Treatment Outcome of Cervicitis of Unknown Etiology.","volume":"40","author":"Taylor","year":"2013","journal-title":"Sex Transm Dis"},{"key":"2026032220061209400_R9","unstructured":"Centers for Disease Control and Prevention. Sexually transmitted infections treatment guidelines, 2021: pelvic inflammatory disease (PID). 2021. Available at https:\/\/www.cdc.gov\/std\/treatment-guidelines\/pid.htm"},{"key":"2026032220061209400_R10","unstructured":"Australasian Society for HIV Viral Hepatitis and Sexual Health Medicine (ASHM). Pelvic inflammatory diseases (PID). 2021. Available at https:\/\/sti.guidelines.org.au\/syndromes\/pelvic-inflammatory-diseases-pid\/"},{"issue":"1","key":"2026032220061209400_R11","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1136\/sextrans-2016-052553","article-title":"Characteristics of pelvic inflammatory disease where no sexually transmitted infection is identified: a cross-sectional analysis of routinely collected sexual health clinic data.","volume":"93","author":"Goller","year":"2017","journal-title":"Sex Transm Infect"},{"key":"2026032220061209400_R12","unstructured":"Melbourne Sexual Health Centre. Pelvic inflammatory disease treatment guidelines. 2021. Available at https:\/\/www.mshc.org.au\/health-professionals\/treatment-guidelines\/pelvic-inflammatory-disease-treatment-guidelines"},{"issue":"21","key":"2026032220061209400_R13","doi-asserted-by":"publisher","first-page":"2039","DOI":"10.1056\/NEJMra1411426","article-title":"Pelvic inflammatory disease.","volume":"372","author":"Brunham","year":"2015","journal-title":"N Engl J Med"},{"issue":"Supplement_2","key":"2026032220061209400_R14","doi-asserted-by":"publisher","first-page":"S29","DOI":"10.1093\/infdis\/jiab067","article-title":"Etiology and diagnosis of pelvic inflammatory disease: looking beyond gonorrhea and chlamydia.","volume":"224","author":"Mitchell","year":"2021","journal-title":"J Infect Dis"},{"key":"2026032220061209400_R15","unstructured":"Australasian Society for HIV Viral Hepatitis and Sexual Health Medicine (ASHM). Cervicitis. 2021. 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