Should you test or treat partners of patients with gonorrhea, chlamydia, or trichomoniasis?
The verdict: Expedited partner therapy works better
A meta-analysis of the above studies evaluated the effect of expedited partner therapy compared with patient referral on the rate of recurrent or persistent gonorrhea, chlamydia, and trichomoniasis and the number of partners treated per index patient.1 Empiric therapy was associated with a lower rate of recurrent or persistent infections (risk ratio [RR]=0.73; 95% confidence interval [CI], 0.57-0.93) and a higher number of partners treated per patient (RR=1.44; 95% CI, 1.12-1.86).
Take state law into account
Providers need to consider their state’s laws regarding empiric partner therapy. A state-by-state evaluation of the legal status of expedited partner therapy is available on the Centers for Disease Control and Prevention’s Web site, and is summarized in TABLE 2.7
TABLE 2
What’s the status of expedited partner therapy (EPT) in your state?7
| EPT is permissible in 20 states: Arizona, California, Colorado, Illinois, Iowa, Louisiana, Minnesota, Mississippi, Nevada, New Hampshire, New Mexico, New York, North Dakota, Oregon, Pennsylvania, Tennessee, Texas, Utah, Washington, and Wyoming. (EPT is also permissible in Baltimore, MD.) |
| EPT is potentially allowable in 21 states: Alabama, Alaska, Connecticut, Delaware, Georgia, Hawaii, Idaho, Indiana, Kansas, Maine, Maryland, Massachusetts, Missouri, Montana, Nebraska, New Jersey, North Carolina, Rhode Island, South Dakota, Virginia, and Wisconsin. (EPT is also potentially allowable in the District of Columbia and Puerto Rico.) |
| EPT is prohibited in 9 states: Arkansas, Florida, Kentucky, Michigan, Ohio, Oklahoma, South Carolina, Vermont, and West Virginia |
Recommendations
A review of expedited partner therapy by the Centers for Disease Control and Prevention concluded: “The evidence indicates that expedited partner therapy should be available to clinicians as an option for partner management…[but it] does not replace other strategies such as standard patient referral or provider-assisted referral, when available…. Expedited partner therapy should be accompanied by information [advising] recipients to seek personal health care in addition to expedited partner therapy. Expedited partner therapy has a limited role in partner management for trichomoniasis. No data support its use in the routine management of syphilis, and there is no experience with expedited partner therapy for gonorrhea or chlamydial infection among men who have sex with men.”8
Neither the American Academy of Family Physicians nor the American College of Obstetricians and Gynecologists has issued a policy statement on expedited partner therapy.
Acknowledgments
The opinions and assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Medical Department of the United States Navy or the US Naval Service at large.
