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P147 A trust-wide audit on pelvic inflammatory disease management in a genitourinary medicine setting
  1. Rebecca Marcus,
  2. Mary Tiab,
  3. Sarah Teague,
  4. Gerard Gorman,
  5. Mags Portman,
  6. Liat Sarner
  1. Barts Health, London, UK

Abstract

Background/introduction Diagnosis and management of pelvic inflammatory disease (PID) in the genitourinary medicine clinic can be challenging. Optimising management is essential in preventing potential sequelae. The national BASHH PID audit (2012) indicated that adherence to guidelines was inconsistent.

Aim(s)/objectives To audit PID management to help inform introduction of new trust guidelines.

Methods Retrospective case note review of all patients with a PID clinic code over six months at three clinics across the trust.

Results Of 184 cases identified, 99.5% of patients had either one or more of PID symptoms: lower abdominal pain, dyspareunia, abnormal bleeding, vaginal discharge. 92% and 97.8% of patients underwent microscopy and STI screening respectively. 16 tested positive for chlamydia, 4 for gonorrhoea, 5 for herpes simplex virus, 2 for trichomonas vaginalis, 47 for bacterial vaginosis (BV), 8 for urinary tract infection (UTI) and 10 for candida. 61% received a recommended treatment regimen, with up to 20 different treatment regimens prescribed. 44% of patients attended for follow-up after two weeks.

Discussion/conclusion In this cohort, there were relatively few STI diagnoses, with BV being the most likely microbiological diagnosis. There was wide variation in prescribing practice and adherence to local and national guidelines. Diagnostic criteria for PID were simplified and disseminated at a trust-wide meeting. New trust guidelines were introduced taking local resistance patterns and national guidance into account.

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