Low Rate of STI Treatment Prescription Filling in Adolescents

Less than 60% of prescriptions for the treatment of STIs in adolescents seeking care in emergency departments were filled.

According to results of a study published in JAMA Pediatrics, less than 60% of prescriptions for the treatment of sexually transmitted infections (STIs) in adolescents seeking care in emergency departments (EDs) were filled.

To investigate how often such prescriptions are filled, investigators used a retrospective cohort study of adolescents aged 13 to 19 years who visited 2 pediatric EDs affiliated with the Children’s National Medical Center. Between January 2016 and December 2017, the researchers obtained data from patients whose encounters resulted in the diagnosis of pelvic inflammatory disease or encounters with positive laboratory results for chlamydia infection for which patients were prescribed outpatient antimicrobials.

A total of 696 ED visits with diagnosed STIs resulted in 65 patients receiving outpatient prescriptions for antimicrobials to treat cervicitis/urethritis and 143 for pelvic inflammatory disease. Of these 208 prescriptions, 57.7% (95% CI, 50.9%-64.5%) were filled. A multivariable analysis found that the single factor associated with prescription filling was hospital admission, at 73.7% vs 18.3% (adjusted odds ratio, 2.25; 95% CI, 1.02-4.99).

Study limitations included a possible lack of generalizability as a result of the study being performed at a single center, as well as the potential for an overestimate of treatment adherence, as prescription filling does not necessarily equal treatment completion.

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According to investigators, adolescents are disproportionately affected by STIs, and “given the astoundingly low rates of prescription filling for STI treatment, it is imperative that novel interventions to improve treatment adherence be explored.” Researchers further recommended that future work strive to understand the barriers to prescription filling to aid the development of targeted, emergency department-based interventions to promote STI-related treatment adherence.


Lieberman A, Badolato GM, Tran J, Goyal MK. Frequency of prescription filling among adolescents prescribed treatment for sexually transmitted infections in the emergency department [published online May 28 2019]. JAMA Pediatr. doi:10.1001/jamapediatrics.2019.1263