In the study, treatment was accelerated by providing packets of antibiotics or mailing medication directly to partners from the pharmacy, without first requiring examination of the partner by a physician. This "expedited treatment" resulted in 68 percent fewer re-infections with gonorrhea and 18 percent fewer re-infections with Chlamydia (or 24 percent, overall, when results for both diseases were combined), according to the study report, which appears in the same edition of the NEJM online Feb 17.
The expedited approach is controversial, say the Hopkins researchers, because most state laws, with the exception of California and Tennessee, do not allow distribution of antibiotics without a physician's examination.
"Traditional approaches to informing partners - in which the patients themselves must notify their sexual partners, who are then expected to seek medical evaluation and treatment - simply do not work well enough, as many patients fail to properly inform their partners, and many partners fail to seek treatment, which leads to re-infection," says lead editorial author and infectious disease specialist Emily Erbelding, M.D., M.P.H., an associate professor at The Johns Hopkins University School of Medicine. "These STDs are persistent in the United States - we are not making much headway in further reducing their overall incidence, and the standard approach to treating partners is one obstacle. Currently, fewer than 20 percent of local health departments in the United States offer assistance with notifying partners to patients with gonorrhea and Chlamydia, leaving
Contact: David March
Johns Hopkins Medical Institutions