Diagnosis and Treatment of Pelvic Inflammatory Disease

Abstract

INTRODUCTION: The Centers for Disease Control and Prevention (CDC) publishes recommendations for the diagnosis and treatment of pelvic inflammatory disease (PID) every 4 years; however, it is unclear whether health care providers adhere to guidelines. This study will determine the rate of clinician compliance with CDC recommendations. METHODS: The Contraceptive CHOICE Project is a prospective cohort study with 9,256 participants in the St Louis region. This substudy is a retrospective chart review of participants within CHOICE who reported a diagnosis of PID in follow-up surveys. Participants were included if they had a confirmed diagnosis of PID through medical records, obtained consent to medical record release, and records were received. Medical records were reviewed and we collected demographics, characteristics, symptoms, and signs at the time of the visit, physical examination findings, diagnostic testing, and prescribed treatment. RESULTS: There were 112 participants who reported being diagnosed with PID on follow-up phone interview (1% CHOICE participants). Eleven participants did not have a recorded diagnosis of PID, and 38 patients did not release their medical records, leaving 63 (56.3%) participants. Abdominal pain was the most common symptom (88.9%) and most patients (77.8%) were found to have at least one of the three minimal requirements for diagnosis of PID. One third of participants (33.3%) received treatment with the recommended regimens. CONCLUSIONS: More than three fourths of patients met CDC minimal criteria for PID; however, only one third of clinicians adhered to CDC treatment. Further education efforts should inform clinicians of evidence-based recommendation for PID therapy.