Treat Adolescents with STIs Before Discharging Them

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Sexually transmitted infections (STIs) are common in adolescents and may lead to significant complications, including abscesses, infertility, and ectopic pregnancies. Although STIs such as chlamydia are easily treated with antibiotics, it is unknown how frequently adolescents actually fill these prescriptions. Using pharmacy and insurance plan data, researchers retrospectively assessed the proportion of antibiotic prescriptions filled by adolescent girls and boys (ages 13 to 19 years) treated for pelvic inflammatory disease or chlamydia at one of two pediatric emergency departments (EDs) in Washington, DC, between 2016 and 2017. Of 208 patients who were prescribed outpatient antibiotics, only 58% of prescriptions were filled. Patients who were hospitalized were more likely to fill their prescription. by: Lauren M. Westafer, DO, MPH, MS reviewing Lieberman A et al. JAMA Pediatr 2019 May 28 link: https://www.jwatch.org/na49237/2019/06/03/treat-adolescents-with-stis-before-discharging-them-ed?query=topic_pedinf&jwd=000013260742&jspc=MPD

COMMENT This study suggests that many adolescents do not fill their antibiotics for STIs, which could lead to subsequent complications as well as prolonged transmission to partners. It is possible that the database used in this study may not have captured all medication fills, thereby underestimating the antibiotic fill rate; however, it is also likely that patients who fill prescriptions may not take the entire course of medication. Given that many STIs can be treated with a single dose of medication, we should administer antibiotics in the ED prior to discharge.