HWN Suggests

You Can Get Your Partner Chlamydia Meds, Too

Chlamydia and gonorrhea differ from viral STIs like herpes and HPV because they can be treated with basic antibiotics: Take a round of meds, it's gone (with some noteworthy exceptions, of course). But it takes two to tango, and if only one-half of a sexual partnership gets treated, it can lead to an easily preventable cycle of reinfection...

Here's how it works: Say I get tested at my doctor's office or an STD clinic, and I'm diagnosed with chlamydia. My health care provider will prescribe me antibiotics—but in states that allow it, I can also get a second prescription in the name of EPT. On that second prescription, the provider should write Expedited Partner Therapy in the name…

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 Expedited Partner Therapy: Helping to Reduce Sexually Transmitted Infections

In cases where gonorrhea expedited partner therapy (provision of prescriptions or medications for the patient to take to his or her sex partner without the health care provider first examining the partner) is permissible by state law and the partner is unable or unlikely to seek timely treatment, the partner may be treated with a single 800 mg dose of cefixime, if a chlamydia infection in the patient has been excluded. If a chlamydia test result has not been documented, the partner may be treated with a single dose of oral cefixime 800 mg plus oral doxycycline 100 mg 2 times/day for 7 days. If adherence with multiday dosing is a considerable concern, azithromycin 1 g can be considered but has lower treatment efficacy among persons with rectal chlamydia.

Articles of Interest

Expedited Partner Therapy Can Stop Sexually Transmitted Infections

The good news is the emergency department can play an important role in curbing the STI public health crisis by using a tool readily at our disposal: EPT. EPT has proven effective at breaking the cycle of STI reinfection. In a meta-analysis, EPT reduced reinfection rates by 29 percent and increased the number of partners treated per patient compared to telling the patient to have their partner treated (ie, simple patient referral).

Expedited partner therapy is an effective way to treat sexually transmitted infections. Why aren’t doctors using it?

As emergency medicine and infectious disease physicians, we often see patients with chlamydia, gonorrhea, and other sexually transmitted infections (STIs). Diagnosing and treating these diseases is generally straightforward. What isn’t straightforward — and is often frustrating and impossible — is treating the person at the other end of the two-way street that makes up an STI.

Legal Status of Expedited Partner Therapy (EPT)

An alternative approach to assuring treatment of partners is expedited partner therapy (EPT). EPT is the delivery of medications or prescriptions by persons infected with an STD to their sex partners without clinical assessment of the partners.

Partner Co-Treatment

All patients experiencing symptoms of STIs or with confirmed STI testing should be encouraged to notify their sex partners and urge them to seek evaluation and treatment when relevant.

The Rules for Treating Partners of Patients with STDs

As nurse practitioners, in most states, prescribing treatment for STDs to partners of patient, in accordance with state guidelines involves relatively little risk. It does, however, ensure better outcomes for our patients, and prevents the spread of these infections overall.

With STDs at an All-Time High, Advocates Push Expedited Partner Therapy

In the wake of COVID-19, with interest high in transmissible diseases, Solnick believes the timing is right for the emergency medicine community to adopt EPT, especially when it is explicitly legal in most states.

Resources

ACOG

Evidence suggests that the benefits of expedited partner therapy in preventing gonorrhea and chlamydial reinfection outweigh the risks of possible adverse effects of antibiotics, development of antibiotic resistance related to poor treatment adherence, or missed care opportunities