Benaim J, Pulaski M, Coupey S M
Tafnit Institute for Adolescents, Jerusalem, Israel.
Arch Pediatr Adolesc Med. 1998 May;152(5):449-54. doi: 10.1001/archpedi.152.5.449.
To describe the experience and practices of emergency department pediatricians in the United States related to the diagnosis and management of pelvic inflammatory disease (PID) in adolescent girls and to compare this experience with Centers for Disease Control and Prevention recommended management guidelines.
National telephone survey.
One hundred four pediatricians randomly selected from the 659 members of the Section on Emergency Medicine of the American Academy of Pediatrics. Response rate was 56%.
A 42-item structured interview questionnaire assessed physician demographics, practice characteristics, PID diagnosis and management, and attitudes about sexually transmitted diseases in adolescents.
Fifty-one (94%) of 54 emergency department pediatricians had diagnosed PID in adolescents at least once within the past 2 years, and 35 (69%) had diagnosed PID, on average, once per month or more. Less than half the pediatricians (23/51 [45%]) routinely recommended hospital admission for adolescents with PID as suggested by the Centers for Disease Control and Prevention, and among those treating adolescents with PID as outpatients,just over half (20/37 [54%]) arranged close follow-up within 72 hours of initiating antibiotic treatment. Although most emergency department pediatricians routinely suggested condom use (47/54 [87%]) and human immunodeficiency virus testing (34/54 [63%]) after diagnosing a sexually transmitted disease, a minority routinely provided contraceptive counseling (23/54 [43%]) or written partner notification (17/54 [31%]). Approximately two thirds of pediatricians surveyed indicated that they thought that the care of an adolescent with a sexually transmitted disease should be different from that of an adult (35/54 [65%]) and that this age group was more prone to medical complications (38/54 [70%]).
The results of this survey suggest that emergency department pediatricians frequently diagnose PID in adolescent girls and understand the high risk of medical complications in this age group, but their management is often less aggressive than that recommended by Centers for Disease Control and Prevention guidelines and sexually transmitted disease experts.
描述美国急诊科儿科医生对青春期女孩盆腔炎（PID）的诊断和管理经验及做法，并将此经验与疾病控制和预防中心推荐的管理指南进行比较。
全国电话调查。
从美国儿科学会急诊医学分会的659名成员中随机抽取104名儿科医生。回复率为56%。
一份包含42个条目的结构化访谈问卷评估了医生的人口统计学特征、执业特点、PID的诊断和管理以及对青少年性传播疾病的态度。
在54名急诊科儿科医生中，有51名（94%）在过去2年内至少诊断过一次青少年PID，平均而言，35名（69%）每月诊断PID一次或更多次。不到一半的儿科医生（23/51 [45%]）按照疾病控制和预防中心的建议常规推荐PID青少年住院治疗，在那些将PID青少年作为门诊患者治疗的医生中，略超过一半（20/37 [54%]）在开始抗生素治疗后72小时内安排密切随访。虽然大多数急诊科儿科医生在诊断性传播疾病后常规建议使用避孕套（47/54 [87%]）和进行人类免疫缺陷病毒检测（34/54 [63%]），但少数医生常规提供避孕咨询（23/54 [43%]）或书面性伴侣通知（17/54 [31%]）。大约三分之二接受调查的儿科医生表示，他们认为对患有性传播疾病的青少年的护理应与成年人不同（35/54 [65%]），并且该年龄组更容易出现医疗并发症（38/54 [70%]）。
本次调查结果表明，急诊科儿科医生经常诊断青春期女孩的PID，并了解该年龄组医疗并发症的高风险，但他们的管理通常不如疾病控制和预防中心指南及性传播疾病专家推荐的那样积极。
