From the Guidelines
The recommended approach for treating partners of patients with sexually transmitted infections (STIs) is expedited partner therapy (EPT), where the infected patient is given an extra prescription or medication to deliver to their sexual partner(s) without requiring the partner to visit a healthcare provider first. For chlamydia, the standard EPT regimen is azithromycin 1 gram as a single oral dose. For gonorrhea, cefixime 800 mg as a single oral dose is typically recommended. For trichomoniasis, metronidazole 2 grams as a single oral dose is the standard treatment. Partners should be instructed to abstain from sexual activity for 7 days after treatment and until symptoms resolve, as stated in the guidelines 1. EPT is particularly valuable for reducing reinfection rates and preventing further transmission in the community. This approach acknowledges the reality that many partners will not seek medical care on their own, leading to continued transmission cycles. However, EPT is not appropriate for all STIs; partners of patients with syphilis, HIV, or complicated infections should be encouraged to seek direct medical evaluation, as noted in the 1993 guidelines 1. Additionally, some jurisdictions have legal restrictions on EPT, so providers should be familiar with local regulations before implementing this approach. The most recent guidelines from 2006 also emphasize the importance of timely treatment of sex partners to decrease the risk of reinfecting the index patient 1. Key considerations for EPT include:
- Ensuring the patient understands the importance of treating their partner(s)
- Providing clear instructions on how to deliver the medication to their partner(s)
- Emphasizing the need for partners to abstain from sexual activity until treatment is completed and symptoms have resolved
- Being aware of local regulations and restrictions on EPT, as mentioned in the guidelines 1.
From the Research
Treatment Approaches for Partners with STIs
- The recommended approach for treating partners with sexually transmitted infections (STIs) can vary depending on the specific infection and the patient's circumstances 2, 3.
- For certain STIs, such as gonorrhea and chlamydia, expedited partner therapy (EPT) may be an option, where the partner is given a prescription for treatment without being seen in person 2.
- EPT can be particularly useful in resource-poor settings or when the partner is unlikely to seek medical attention otherwise 4.
- However, it's essential to consider the potential drawbacks of single-dose therapy, including reduced efficacy in certain situations and the risk of antimicrobial resistance 5.
Single-Dose Therapy for STIs
- Single-dose therapy has been shown to be effective for certain STIs, such as gonorrhea, chlamydia, and trichomoniasis 6, 5, 4.
- Azithromycin, in particular, has been found to be a convenient and effective treatment option for chlamydia and other STIs 6, 4.
- However, single-dose therapy may not be suitable for all STIs, and the potential risks and benefits should be carefully considered on a case-by-case basis 5.
Importance of Medical Evaluation
- While EPT and single-dose therapy can be useful tools in the management of STIs, it's essential to ensure that patients receive a thorough medical evaluation and follow-up care as needed 2, 3.
- Medical evaluation can help identify any potential complications or co-infections and ensure that patients receive appropriate treatment and counseling 3.