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Child/Adolescent Health

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Most teenagers with chlamydial infections receive appropriate antibiotics, but fewer receive other recommended care

The rate of Chlamydia trachomatis (CT) infection, a sexually transmitted infection (STI), among adolescents aged 15 to 19 years is 5 times the overall national rate. This usually asymptomatic infection can progress to pelvic inflammatory disease, which can lead to tubal pregnancy, chronic pelvic pain, and infertility in females. Most teenagers receive appropriate antibiotics for the infection; however, other recommended care, such as counseling about high-risk sexual behaviors than can lead to CT infection, management of sexual partners, testing for other STIs, and retesting for reinfection with CT, is sometimes not provided.

Researchers, supported in part by the Agency for Healthcare Research and Quality (HS10537), reviewed the medical charts of 122 sexually active 14- to 19-year-old adolescents, who tested positive for CT infection in 2001 at 5 pediatric clinics of a large California health maintenance organization. They examined documentation of treatment and followup treatment for CT. The adolescents were followed for 20 months at 4 sites and for 4 months at 1 one site. All but four teenagers (97 percent) were treated with appropriate antibiotics in a timely fashion.

During followup, safer-sex counseling was documented for 79 percent of the patients. Partner management was addressed for 52 percent. However, only 36 percent of the patients were tested for other STIs (which are significant common among CT-infected adolescents), and only 10 percent received recommended CT retesting during the recommended 3 to 12 months after CT treatment. Significantly fewer boys than girls received safer-sex counseling and partner management, leaving their female partners potentially at risk for continuing to be infected and untreated.

See "Examination of the treatment and followup care for adolescents who test positive for Chlamydia trachomatis infection," by Loris Y. Hwang, M.D., Kathleen P. Tebb, Ph.D., Mary-Ann B. Shafer, M.D., and Robert H. Pantell, M.D., in the December 2005 Archives of Pediatric and Adolescent Medicine 159, pp. 1162-1166.

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