Aim To audit the care of Pelvic Inflammatory Disease (PID) in a city centre Genitourinary medicine clinic.
Objectives (1) To assess the effectiveness of PID treatment offered by evaluating the auditable outcomes recommended within BASHH treatment guidelines. (2) To ascertain the level of detected infection with Neisseria gonorrhoeae in order to decide whether to implement IM ceftriaxone 500 mg stat as part of all PID treatment as per latest BASHH 2011 treatment guidelines.
Method A retrospective review of patient case notes coded with B4/B5, C4A and C5 from June 2010 till December 2010. A proforma was formulated and results then analysed using SPSS.
Results A total of 87 case notes were analysed. 100% of the patients were offered microbiological investigations (target—>95%) and 87.4% of the patients were treated with recommended regimens (target—>95%). 89.7% of the patients were referred for contact tracing (target—>95%) and the ratio of number of contacts screened/treated was 0.21 (target 0.4).
Discussion Only one audit outcome (>95%—microbiological investigations) was achieved. Gonococcal PID was confirmed on microbiological testing in only 2/87 patients (2.3%).
Conclusion We propose the introduction of a PID proforma to ensure greater uniformity of management and improve auditable outcomes. A local PID clinical guideline was adopted advising treating those at low risk of gonoccocal infection and mild to moderate PID with doxycycline plus metronidazole; and to add in IM ceftriaxone 500 mg stat to those with moderate to severe PID and/or those at high risk of gonoccocal disease. Re-audit will be conducted after the introduction of these measures.
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