Identifying a need for more focused treatment of XXXX and gonorrhoea in the emergency department.

@entity1 @entity1047
UNASSIGNED: The indolent nature of @entity1047 and gonorrhoea along with the time delay associated with current diagnostic testing makes definitive diagnosis while in the emergency department impossible. We therefore sought to determine the proportion of @entity1 who receive accurate, presumptive antimicrobial treatment for these infections. A retrospective chart review was performed on all @entity1 encounters that underwent @entity1047 and gonorrhoea testing at an urban emergency department during a single month in 2012. Each encounter was reviewed for nucleic acid amplification test results and whether presumptive antibiotics were given during the initial visit. A total of 639 @entity1 encounters were reviewed; 87.2% were female and the mean age was 26.7 years. @entity1047 was present in 11.1%, with @entity1 and @entity1 having similar infection rates, 10.6% vs. 14.6% (p   =   0.277). Gonorrhoea was present in 5.0%, with lower prevalence among @entity1 than @entity1 , 3.2% vs. 17.1% (p   <   0.001). @entity1 received presumptive treatment less often than @entity1 , 37.7% vs. 82.9% (p   <   0.001). Presumptive treatment was less accurate in @entity1 than @entity1 , 7.9% vs. 25.6% (p   <   0.001). After combining genders, 10.2% received accurate presumptive treatment; 33.3% were overtreated and 4.4% missed treatment. Presumptive treatment for @entity1047 and gonorrhoea was more frequent and more accurate in @entity1 than in @entity1 . Overall, one-third of @entity1 received unnecessary antibiotics, yet nearly 5% missed treatment. Better methods are needed for identifying @entity1 who need treatment.
