A new report shows that a substantial number of teenagers diagnosed with STDs in emergency rooms may not receive appropriate treatment. Dr. Kathleen R. Beckmann and colleagues at Children's Hospital of Wisconsin studied data covering 1.2 million adolescent visits to ERs over a seven-year period. Of the 351 patients selected for the study, most (92 percent) were female and the most common diagnosis was pelvic inflammatory disease (PID) -- (44 percent of cases).

The researchers found that only 80 percent of patients with any STD were treated with antibiotics or admitted to the hospital. The finding was true for 91 percent of PID patients and 71 percent of patients with other STDs.

Only 27 percent of female patients with PID received the full treatment recommended in public health guidelines. Less than half of female STD patients had a pregnancy test, and only one such patient was tested for HIV.

Male patients were more likely than female patients to receive treatment for STDs, but Hispanic patients were less likely than non-Hispanic whites to be treated.

"Further work is necessary to explain these disparities and optimize care for adolescents who have sexually transmitted infections and present to emergency departments," the authors concluded. "Most important, efforts should focus on better implementation of existing guidelines."

The report, "Emergency Department Management of Sexually Transmitted Infections in U.S. Adolescents: Results from the National Hospital Ambulatory Medical Care Survey," appeared in Annals of Emergency Medicine (2004;43(3):333-338).

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