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The following is a summary of “Implementation of a 90-minute gonorrhea/chlamydia test decreases antibiotic under–and overtreatment in female emergency department patients,” published in the March 2025 issue of Journal of Emergency Medicine by Chinnock et al. 

Prolonged turnaround times (TAT) for emergency department (ED) Nucleic acid amplification testing (NAAT) testing of Chlamydia trachomatis and Neisseria gonorrhoeae (CT/NG) in women contribute to significant under- and overtreatment.  

Researchers conducted a retrospective study to assess whether under- and overtreatment rates decreased in an ED using a newer NAAT with a 90-minute TAT compared to an ED without this test.  

They examined females tested for CT/NG in the ED, comparing under and overtreatment rates across 2 different 70-week periods before and after implementing a 90-minute TAT in the intervention ED (ED-I), with no change in the control ED (ED-C). An interrupted time series analysis was executed to estimate the impact of the intervention.  

The results showed that a total of 10,064 CT/NG tests were conducted in ED-I and 1,990 in the ED-C. In the ED-I, undertreatment decreased from 37% to 19% (18% decrease; 95% CI -17% to -20%), while in the ED-C, it declined from 42% to 40% (2% decrease; 95% CI -7% to 2%). Overtreatment in the ED-I dropped from 27% to 17% (10% decrease; 95% CI -8% to -11%), whereas in the ED-C, it decreased from 37% to 33% (4% decrease; 95% CI -8% to 1%).  

Investigators concluded that a 90-minute TAT in a real-world ED study reduced under- and overtreatment rates for female patients tested for CT/NG, suggesting further improvements with shorter TATs and faster specimen collection. 

Source: jem-journal.com/article/S0736-4679(25)00090-3/fulltext