{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T00:04:36Z","timestamp":1780617876313,"version":"3.54.1"},"reference-count":14,"publisher":"CSIRO Publishing","issue":"3","license":[{"start":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T00:00:00Z","timestamp":1779926400000},"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":[[2026,6,15]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The Centers for Disease Control and Prevention (CDC) has identified drug-resistant Neisseria gonorrhoeae as an urgent public health threat, highlighting the importance of antimicrobial stewardship. This study evaluated the implementation of point-of-care (POC) nucleic acid amplification (NAA) testing for chlamydia and gonnorhea among males presenting with urethritis at an urban public sexually transmitted infections (STI) clinic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>POC urine NAA testing was performed for males presenting with symptoms of urethritis and\/or urethral discharge, as well as asymptomatic males reporting STI exposure. Patients with with laboratory-confirmed infections were treated according to CDC STI treatment guidelines: for chlamydia, patients were treated with doxycycline 100\u00a0mg orally twice daily for 7 days;\u00a0for gonorrhea, patients were treated with a single 500-mg intramuscular dose of ceftriaxone. Patients testing negative for both infections were managed for non-gonococcal urethritis with doxycycline, or in select cases, received no empiric therapy. Reductions in antibiotic use were compared with standard syndromic management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 385 POC tests were analysed. Gonorrhea was detected in 40 patients (10.4%), chlamydia in 29 (7.5%), and both infections in five (1.3%), while 311 (80.8%) were negative. Forty-seven patients received ceftriaxone, representing an absolute reduction of 338 doses (87.8% relative reduction). Doxycycline was dispensed to 193 patients, representing an absolute reduction of 192 doses (49.9% relative reduction).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Implementation of POC NAA testing for chlamydia and gonorrhea in male patients presenting with urethritis improved antimicrobial stewardship by significantly reducing unnecessary empiric use of antibiotics in an urban STI clinic setting.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1071\/sh25254","type":"journal-article","created":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T23:41:26Z","timestamp":1780616486000},"source":"Crossref","is-referenced-by-count":0,"title":["Improving antimicrobial stewardship in an urban STI clinic: from syndromic management to targeted antibiotic treatment of male urethritis using point-of-care chlamydia and gonorrhea testing"],"prefix":"10.1071","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6286-335X","authenticated-orcid":true,"given":"Shira","family":"Heisler","sequence":"first","affiliation":[{"name":"AWayne State University, Detroit, MI, USA."},{"name":"BDetroit Public Health STD Clinic, Detroit, MI, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brianna","family":"Kline","sequence":"additional","affiliation":[{"name":"AWayne State University, Detroit, MI, USA."},{"name":"BDetroit Public Health STD Clinic, Detroit, MI, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-4041-1314","authenticated-orcid":true,"given":"Cindy","family":"Sullins","sequence":"additional","affiliation":[{"name":"BDetroit Public Health STD Clinic, Detroit, MI, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"67","published-online":{"date-parts":[[2026,6,5]]},"reference":[{"key":"2026060419412320500_R1","unstructured":"Centers for Disease Control and Prevention. About gonorrhea. CDC; 2025. Available at https:\/\/www.cdc.gov\/gonorrhea\/about\/index.html [accessed 31 January 2025]"},{"key":"2026060419412320500_R2","unstructured":"Centers for Disease Control and Prevention. Sexually transmitted infections surveillance, 2024 (provisional). CDC; 2025. Available at https:\/\/www.cdc.gov\/sti-statistics\/annual\/ [accessed 24 September 2025]"},{"key":"2026060419412320500_R3","unstructured":"Michigan Department of Health and Human Services. STI annual diagnosis and trends in Michigan, 2024. MDHHS; 2025. Available at https:\/\/www.michigan.gov\/mdhhs\/-\/media\/Project\/Websites\/mdhhs\/Keeping-Michigan-Healthy\/HIVSTI\/Data-and-Statistics\/2025\/2024-STIs-and-Trends-in-Michigan-Overview.pdf [accessed 15 July 2025]"},{"key":"2026060419412320500_R4","unstructured":"Centers for Disease Control and Prevention. Drug-resistant gonorrhea. CDC; 2024. Available at https:\/\/www.cdc.gov\/gonorrhea\/hcp\/drug-resistant\/index.html [accessed 14 February 2024]"},{"key":"2026060419412320500_R5","unstructured":"Centers for Disease Control and Prevention. Antibiotic resistance threats in the United States, 2019. CDC; 2019. Available at https:\/\/www.cdc.gov\/antimicrobial-resistance\/media\/pdfs\/2019-ar-threats-report-508.pdf [accessed December 2019]"},{"key":"2026060419412320500_R6","unstructured":"U.S. Food and Drug Administration. Rationale for FDA\u2019s position on an azithromycin susceptible only breakpoint for Neisseria gonorrhoeae. FDA; 2021. Available at https:\/\/www.fda.gov\/drugs\/development-resources\/rationale-fdas-position-azithromycin-susceptible-only-breakpoint-neisseria-gonorrhoeae [accessed 14 October 2021]"},{"issue":"6","key":"2026060419412320500_R7","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1177\/2042098614554919","article-title":"Antimicrobial resistance: risk associated with antibiotic overuse and initiatives to reduce the problem.","volume":"5","author":"Llor","year":"2014","journal-title":"Ther Adv Drug Saf"},{"key":"2026060419412320500_R8","unstructured":"Centers for Disease Control and Prevention. Antibiotic use in the United States. CDC; 2025. Available at https:\/\/www.cdc.gov\/antibiotic-use\/hcp\/data-research\/antibiotic-prescribing.html [accessed 15 September 2025]"},{"key":"2026060419412320500_R9","unstructured":"Centers for Disease Control and Prevention. Outpatient antibiotic prescriptions 2024 report. CDC; 2024. Available at https:\/\/www.cdc.gov\/antibiotic-use\/media\/pdfs\/2024-Annual-Report-508.pdf [accessed 2024]"},{"issue":"19","key":"2026060419412320500_R10","doi-asserted-by":"publisher","first-page":"1931","DOI":"10.1001\/jama.2021.7164","article-title":"News from the Food and Drug Administration: point-of-care test for sexually transmitted infections.","volume":"325","author":"Jaklevic","year":"2021","journal-title":"JAMA"},{"issue":"5","key":"2026060419412320500_R11","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.4819","article-title":"Evaluation of the performance of a point-of-care test for chlamydia and gonorrhea.","volume":"3","author":"Van Der Pol","year":"2020","journal-title":"JAMA Netw Open"},{"issue":"5","key":"2026060419412320500_R12","first-page":"575","article-title":"Binx IO point-of-care test for Chlamydia trachomatis and Neisseria gonorrhoeae infections.","volume":"106","author":"Clebak","year":"2022","journal-title":"Am Fam Physician"},{"key":"2026060419412320500_R13","unstructured":"World Health Organization. Guidelines for the Management of Sexually Transmitted Infections. WHO; 2003. Available at https:\/\/applications.emro.who.int\/aiecf\/web79.pdf [accessed 2023]"},{"issue":"4","key":"2026060419412320500_R14","doi-asserted-by":"publisher","first-page":"847","DOI":"10.1097\/GRF.0000000000000714","article-title":"Syndromic treatment of STIs in low-income countries is inadequate: current threats and future directions.","volume":"65","author":"Kopkin","year":"2022","journal-title":"Clin Obstet Gynecol"}],"container-title":["Sexual Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/connectsci.au\/sh\/article-pdf\/doi\/10.1071\/SH25254\/1869992\/sh25254.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/connectsci.au\/sh\/article-pdf\/doi\/10.1071\/SH25254\/1869992\/sh25254.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T23:41:32Z","timestamp":1780616492000},"score":1,"resource":{"primary":{"URL":"https:\/\/connectsci.au\/sh\/article\/23\/3\/SH25254\/273025\/Improving-antimicrobial-stewardship-in-an-urban"}},"subtitle":[],"editor":[{"given":"Jami","family":"Leichliter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,6,5]]},"references-count":14,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,6,15]]}},"URL":"https:\/\/doi.org\/10.1071\/sh25254","relation":{},"ISSN":["1448-5028","1449-8987"],"issn-type":[{"value":"1448-5028","type":"print"},{"value":"1449-8987","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,5]]},"article-number":"SH25254"}}