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I work in two different clinical practice settings, an inner city academic free standing pediatric hospital and a community based suburban/rural general hospital with a peds ED.

At the Children’s Hospital we need to utilize clinical judgement in deciding whether to treat.  When ordering these tests in adolescent patients, our treatment threshold is very low, given the challenges of reaching patients for follow up and the issues of confidentiality that were alluded to in the original post.

At the community hospital our lab recently started providing real time reporting of GC/CT PCR as well as PCR vaginitis panel (trich, candida, gardnerella).  Results are provided 24/7, usually within 45-60 mins.  The rapid turn around results are new, so we will need to see how it works out.  In theory, this is a wonderful solution as it allows for rational treatment decisions and should reduce over-treatment and reduce the ethical challenges of reaching out to patients/caretakers after they have left the dept.


Zach

Zach Kassutto, MD, FAAP
Capital Health
Hopewell, NJ

St. Christopher’s Hospital for Children
Phila., PA

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From: Placid Bone <[log in to unmask]<mailto:[log in to unmask]>>
Subject: To wait for culture or treat in peds STI
Date: May 6, 2014 at 1:42:27 PM EDT


Our ED  has been sending GC/chylamdia cultures-gen probe, and waiting for the results prior to treatment for STI in the adolescent population. This gets tricky trying to call in antibiotics for a minor without parental knowledge.  Just wondering if other hospitals are waiting for the cultures in order to avoid unnecessary antibiotics usage or just treating?

Thank you
placid bone

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From: Gill Winnik <[log in to unmask]<mailto:[log in to unmask]>>
Subject: Re: To wait for culture or treat in peds STI
Date: May 6, 2014 at 4:00:26 PM EDT


With clinical suspicion I would treat.


Giora
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