Massachusetts General Hospital, Boston, MA, USA.
Brigham and Women's Hospital, Boston, MA, USA.
J Prim Care Community Health. 2021 Jan-Dec;12:21501327211044060. doi: 10.1177/21501327211044060.
Directly observed therapy (DOT) is recommended for the treatment of chlamydia, however pharmacy prescriptions are frequently used. Adherence to DOT and the association between treatment method and time to treatment is unknown.
We conducted a retrospective review of a randomized 2% of laboratory-confirmed chlamydia infections reported to the Massachusetts Department of Public Health from January 1, 2019 to May 31, 2019. Clinicians and pharmacies were contacted to ascertain treatment methods and timing. We assessed frequency of DOT and pharmacy prescriptions in the treatment of chlamydia infection in Massachusetts. We used log rank test to compare time to treatment initiation for patients receiving DOT versus pharmacy prescriptions. Data were stratified according to whether treatment was empiric or laboratory-driven.
We ascertained full outcomes for 199 patients. Eighty patients received DOT and 119 patients received pharmacy prescriptions. DOT was more common among those receiving empiric treatment and pharmacy prescriptions were more common among those receiving laboratory-driven treatment. The median time to treatment was 1.5 days for patients treated with DOT and 3 days for those treated with pharmacy prescriptions. For both groups, the median time to treatment for empiric therapy was 0 days and for laboratory-driven therapy was 4 days. The differences in time to treatment were not statistically significant.
Pharmacy prescriptions are frequently used for the treatment of chlamydia in Massachusetts. We did not observe a significant difference in the time to treatment between DOT and pharmacy prescriptions.
直接观察治疗（DOT）被推荐用于治疗衣原体，但经常使用药房处方。DOT 的依从性以及治疗方法与治疗时间之间的关系尚不清楚。
我们对 2019 年 1 月 1 日至 2019 年 5 月 31 日向马萨诸塞州公共卫生部报告的随机选择的 2%实验室确诊的衣原体感染进行了回顾性审查。联系临床医生和药房以确定治疗方法和治疗时间。我们评估了马萨诸塞州 DOT 和药房处方治疗衣原体感染的频率。我们使用对数秩检验比较接受 DOT 与药房处方治疗的患者开始治疗的时间。根据治疗是经验性还是基于实验室的，对数据进行分层。
我们确定了 199 名患者的全部结局。80 名患者接受 DOT，119 名患者接受药房处方。在接受经验性治疗的患者中，DOT 更为常见，而在接受基于实验室的治疗的患者中，药房处方更为常见。接受 DOT 治疗的患者的中位治疗时间为 1.5 天，而接受药房处方治疗的患者的中位治疗时间为 3 天。对于两组，经验性治疗的中位治疗时间为 0 天，基于实验室的治疗的中位治疗时间为 4 天。治疗时间的差异无统计学意义。
在马萨诸塞州，药房处方经常用于治疗衣原体。我们没有观察到 DOT 和药房处方在治疗时间上的显著差异。
