• Jenna Garlock, Leborah Lee, Michaelia Cucci, Lawrence A Frazee, and Chanda Mullen.
• Cleveland Clinic Akron General, 1 Akron General Avenue, Akron, OH 44307, United States of America. Electronic address: GarlocJ@ccf.org.
• Am J Emerg Med. 2019 May 1; 37 (5): 884-889.

BackgroundIn the ED, patients are treated empirically for suspected gonorrhea and/or chlamydia (GC). Limited studies have evaluated the treatment of sexually transmitted diseases (STDs) in conjunction with predictor variables. This study will allow providers to better identify patients with potential GC to streamline antibiotic treatment.ObjectivesThe primary objective was to determine the incidence of positive assay in patients that underwent GC screening. The secondary objectives included the proportion of patients assayed that received empiric therapy and the predictive value of risk factors to identify positive assays.MethodsThis retrospective cohort study included adult patients who presented to the health-system EDs and underwent GC screening. Subjects were excluded if they were victims of sexual assault, left AMA or eloped.ResultsA total of 490 assayed patients were included, of which 84 (17%) were found to be positive for GC assay. Of the 278 patients treated empirically, 74% had a negative assay. Of the entire sample (n = 490), risk factors found to predict a positive assay (p < 0.05) included male, women <25 years of age, concomitant bacterial vaginosis, pelvic inflammatory disease or trichomonas, penile discharge, inconsistent condom use, previous/coexisting STDs, and uninsured.ConclusionsCompared to previous reports, this study found a higher incidence of positive GC assays for patients with suspected infection. This is the first study to evaluate GC testing in both men and women in the ED, and risk factors not previously reported by the CDC were identified.Copyright © 2018 Elsevier Inc. All rights reserved.

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