Assessment of Office-Based Care of SexuallyTransmitted Diseases and Vaginitis and AntibioticDecision-Making by Obstetrician-Gynecologists

[摘要] Objective:Survey office-based obstetric-gynecologic practitioners regarding their knowledge of infectiousdisease care and antibiotic use.Methods:A survey questionnaire of multiple-choice questions was mailed to Fellows of theAmerican College of Obstetricians and Gynecologists about clinical entities for which recommendationshave undergone recent changes or about which there was a lack of consensus in a priorsimilar survey (Gibbs RS, McGregor JA, Mead PB, et al.: Obstet Gynecol 83:631–636, 1994).Results:Respondents indicated that oral metronidazole was their most frequent choice to treatbacterial vaginosis. Ampicillin (57%) was used more often than penicillin (39%) for intrapartumgroup B streptococcus prophylaxis. Azithromycin was preferred (61%) over erythromycin-base(38%) for chlamydia treatment during pregnancy. There were several modes of practice that deviatedfrom accepted care: 27% and 29% did not screen for chlamydia and gonorrhea, respectively,in pregnancy; 17% used cultures forGardnerella vaginalisto diagnose bacterial vaginosis; 25%considered quinolones to be safe in pregnancy; 93% felt metronidazole should never be used inpregnancy; and the majority (66%) would send a patient treated successfully for pelvic cellulitishome with an oral antibiotic.Conclusion:Respondents’ infectious disease knowledge and practices in obstetrics and gynecologyis appropriate in treating sexually transmitted diseases, bacterial vaginosis, and group B streptococcus.Numerous deficiencies still exist in screening for sexually transmitted diseases in pregnancyand diagnosing bacterial vaginosis, as well as in the choice of antibiotics to use or avoid forcertain infections.

[学科分类] 妇产科学