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Sexual Partners Should Get Expedited Treatment for Chlamydia and Gonorrhea

Male sexual partners of women diagnosed with chlamydia or gonorrhea should be prescribed antibiotics in an effort to prevent passing infections back and forth, according to new guidelines from the American College of Obstetricians and Gynecologists (ACOG).

According to the recommendation, which appears in the September 2011 issue of Obstetrics and Gynecology, ob-gyns are encouraged to give female patients antibiotic prescriptions or pills to take to their partners -- a practice dubbed "expedited partner therapy" -- to reduce delayed treatment and partners' reluctance to seek care.

Below is an edited excerpt from a press release issued by ACOG summarizing the recommendation.

Expedited Partner Therapy Recommended to Prevent STI Reinfection

Washington, DC -- August 22, 2011 -- Ob-gyns are encouraged to prescribe antibiotics for the male partners of their female patients diagnosed with chlamydia or gonorrhea to reduce the high reinfection rate, says The American College of Obstetricians and Gynecologists (The College) in a new Committee Opinion issued today. This practice, known as "expedited partner therapy" (EPT), allows doctors to provide prescriptions for antibiotics or the antibiotics themselves to female patients to take to their male partners who are either unlikely or unable to go to the doctor.

Sexually transmitted infections (STIs) disproportionately affect women and pose a significant, yet preventable, threat to their fertility. Chlamydia and gonorrhea are the top two most commonly reported STIs in the US, and girls and young women ages 15-24 have the highest number of cases of both. The 12-month reinfection rate of chlamydia among adolescents and young women is as high as 26%, often due to an untreated male sexual partner.

"Evidence indicates that EPT can decrease reinfection rates compared to standard partner referrals for examination and treatment," said Diane F. Merritt, MD, chair of The College's Committee on Adolescent Health Care. "Of course, it's preferable that a physician examine a patient in-person before prescribing medication, but the benefits of EPT among individuals whose partners are otherwise unlikely to seek care in preventing chlamydia and gonorrhea reinfections outweigh the risks to the partners."

Chlamydia and gonorrhea are infections that may not cause symptoms, or if they do, they're vague (vaginal or penile discharge, abnormal vaginal bleeding, cramping). "Many people who have an STI are not aware of it and pass it to their partners," said Dr. Merritt. "Undiagnosed and untreated STIs can cause scarring and damage a woman's ability to become pregnant when she's ready to have a baby. Fortunately, chlamydia and gonorrhea can be quickly diagnosed with a simple urine test and treated with a short course of antibiotics."

According to The College, the practice of prescribing antibiotics to non-patients without prior examination is permissible in 27 states, potentially allowable in 15 other states, and prohibited in 8 states. The College encourages ob-gyns to push for legalization of expedited partner therapy in those states and jurisdictions where it's illegal or where the legal status of EPT is unclear or ambiguous.

9/16/11

Reference

American College of Obstetricians and Gynecologists. Committee Opinion No. 506: Expedited Partner Therapy in the Management of Gonorrhea and Chlamydia by Obstetrician-Gynecologists. Obstetrics and Gynecology 118(3):761-766. September 2011.

Other Source

American College of Obstetricians and Gynecologists. Expedited Partner Therapy Recommended to Prevent STI Reinfection. Press release. August 22, 2011.