{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T12:33:26Z","timestamp":1791203606483,"version":"4.2.0"},"reference-count":31,"publisher":"BMJ","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2013,2,15]]},"published-print":{"date-parts":[[2013,9]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>We aimed to examine the impact of a point-of-care (POC) test on overtreatment and undertreatment of sexually transmitted infections (STIs) by comparing treatment patterns for gonorrhoea (detected with nucleic acid amplification testing (NAAT)) with trichomoniasis (detected by POC test) for young women seen in an emergency department (ED).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We reviewed the database of a quality improvement (QI) project that aims to improve follow-up care for STIs in the ED. Data included the test result and antibiotic given (if any) during visits by women age 14\u201321 for whom an STI test was ordered. We generated Shewhart control charts and compared overtreatment and undertreatment rates for gonorrhoea and trichomoniasis using \u03c7<jats:sup>2<\/jats:sup>testing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 1877 visits over 18\u2005months, 8.8% of women had gonorrhoea and 16.5% had trichomoniasis. Overtreatment was higher for women with gonorrhoea than trichomoniasis (54% vs 23%, p&lt;0.001). Overtreatment for gonorrhoea decreased from 58% to 47% (p&lt;0.01) and overtreatment for trichomoniasis decreased from 24% to 18% (p&lt;0.01), which corresponded to improvements in patient follow-up for the QI project. Undertreatment was higher for women with gonorrhoea than trichomoniasis (29% vs 21%, p=0.03), and did not change over time.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A POC test improves the accuracy of STI care in an ED compared with NAAT testing. An unanticipated benefit of QI efforts to improve patient follow-up is the observed decrease in antibiotic use in the ED. Given the ability of gonorrhoea to develop antibiotic resistance, future efforts should focus on development of an accurate POC test for gonorrhoea.<\/jats:p><\/jats:sec>","DOI":"10.1136\/sextrans-2012-050994","type":"journal-article","created":{"date-parts":[[2013,3,8]],"date-time":"2013-03-08T03:15:23Z","timestamp":1362712523000},"page":"489-494","source":"Crossref","is-referenced-by-count":28,"title":["Point-of-care testing improves accuracy of STI care in an emergency department"],"prefix":"10.1136","volume":"89","author":[{"given":"Jill S","family":"Huppert","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Regina G","family":"Taylor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"St Cyr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth A","family":"Hesse","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer L","family":"Reed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2013,3,7]]},"reference":[{"key":"2024051410071128000_89.6.489.1","unstructured":"Centers for Disease Control and Prevention (CDC). Sexually transmitted disease surveillance, 2010. In: Gonorrhea. 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Chapter 2: Testing a change. Appendix A: Improvement using control charts. Quality improvement through planned experimentation. 2nd edn. New York: McGraw-Hill, 1999:21\u201346; 379\u2013410."},{"key":"2024051410071128000_89.6.489.17","doi-asserted-by":"publisher","DOI":"10.1136\/sti.2006.021824"},{"key":"2024051410071128000_89.6.489.18","doi-asserted-by":"publisher","DOI":"10.1053\/ajem.2001.24478"},{"key":"2024051410071128000_89.6.489.19","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2006.12.010"},{"key":"2024051410071128000_89.6.489.20","doi-asserted-by":"publisher","DOI":"10.1080\/10852352.2011.576973"},{"key":"2024051410071128000_89.6.489.21","unstructured":"Centers for Disease Control and Prevention (CDC). Cervicitis. Sexually transmitted disease treatment guidelines. Atlanta, Georgia: US Department of Health and Human Services, 2011:43\u20139."},{"key":"2024051410071128000_89.6.489.22","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1097\/00007435-200101000-00008","article-title":"Unsuspected gonorrhea and chlamydia in patients of an urban adult emergency department: a critical population for STD control intervention","volume":"28","author":"Mehta","year":"2001","journal-title":"Sex Transm Dis"},{"key":"2024051410071128000_89.6.489.23","first-page":"62","article-title":"Sexually transmitted diseases treatment guidelines, 2010\u2014pelvic inflammatory disease","volume":"59","author":"Workowski","year":"2010","journal-title":"MMWR Recomm Rep"},{"key":"2024051410071128000_89.6.489.24","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1056\/NEJM198407193110301","article-title":"Treatment of penicillin-resistant Neisseria gonorrhoeae with oral norfloxacin","volume":"311","author":"Crider","year":"1984","journal-title":"N Engl J Med"},{"key":"2024051410071128000_89.6.489.25","doi-asserted-by":"publisher","DOI":"10.1097\/00007435-198907000-00003"},{"key":"2024051410071128000_89.6.489.26","doi-asserted-by":"publisher","DOI":"10.1016\/j.idc.2005.03.005"},{"key":"2024051410071128000_89.6.489.27","doi-asserted-by":"publisher","DOI":"10.1517\/14656560902731993"},{"key":"2024051410071128000_89.6.489.28","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cir929"},{"key":"2024051410071128000_89.6.489.29","unstructured":"Centers for Disease Control and Prevention (CDC). 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Handb Exp Pharmacol 2012;(211 Special issue on Trichomonas vaginalis):45\u201365.","DOI":"10.1007\/978-3-642-28951-4_4"}],"container-title":["Sexually Transmitted Infections"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/sextrans-2012-050994","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,14]],"date-time":"2024-05-14T17:08:14Z","timestamp":1715706494000},"score":1,"resource":{"primary":{"URL":"https:\/\/sti.bmj.com\/lookup\/doi\/10.1136\/sextrans-2012-050994"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,3,7]]},"references-count":31,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2013,8,16]]},"published-print":{"date-parts":[[2013,9]]}},"alternative-id":["10.1136\/sextrans-2012-050994"],"URL":"https:\/\/doi.org\/10.1136\/sextrans-2012-050994","relation":{},"ISSN":["1368-4973","1472-3263"],"issn-type":[{"value":"1368-4973","type":"print"},{"value":"1472-3263","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,3,7]]}}}