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Antibiotics-to-go may increase STD treatment

Sexual HealthAug 19, 05

Take-home antibiotics may be an effective way to ensure that the partners of men with certain Sexually Transmitted Diseases (STDs) get treatment, a new study suggests.

Researchers found that giving male STD patients a dose of antibiotics to bring to their partners appeared more effective than the traditional method for getting at-risk partners treated.

Typically, people with STDs like chlamydia and Gonorrhea are instructed to tell all their sexual partners to see a doctor for testing and treatment. But studies have suggested that relatively few partners ever get treated, and in some places in the U.S. clinics are trying a new tactic, known as patient-delivered partner treatment.

In these cases, patients with chlamydia or Gonorrhea—two common bacterial STDs—are given a dose of antibiotics, along with written instructions on how to use the medication, to pass on to their sexual partners.

The practice is already common in Europe but has been slow to catch on in the U.S., said Dr. Patricia Kissinger of Tulane University in New Orleans, the lead author of the new study.

One obstacle is that some doctors worry about their legal liability if a patient’s partner were to have side effects from treatment. But, Kissinger told Reuters Health, there is little risk of side effects from the single-dose antibiotics used to treat chlamydia and gonorrhea.

Still, only three U.S. states have made patient-delivered treatment “explicitly legal,” Kissinger said, and similar measures in other states may be needed before the practice becomes more routine.

Her team’s study, published in the journal Clinical Infectious Diseases, involved 977 men who received treatment for chlamydia or gonorrhea at a public STD clinic in New Orleans.

Patients were randomly assigned to one of three groups. Men in one group were instructed to tell their partners to seek testing and treatment; a second group also received information cards to give to their partners; the third group received a single dose of antibiotics for up to four partners.

When the men were interviewed a month later, 56 percent of those given antibiotics said their partners had taken the medication. Only 35 percent of those in the traditional partner-referral group said their partners had gotten treatment.

In addition, the researchers found, men who received antibiotics for their partners were less likely to have a recurrent infection at the one-month mark.

For women, infection with chlamydia or gonorrhea can lead to pelvic inflammatory disease and infertility, making it vital to track and treat an infected man’s female partners.

The current study and similar ones, according to Kissinger, have “made it pretty obvious” that patient-delivered antibiotics can help achieve this goal.

The tactic is not appropriate for all STDs, however, she pointed out. In the case of syphilis, a serious disease linked to an increased risk of
HIV, public health professionals contact patients’ partners themselves to ensure that they know of their risk.

SOURCE: Clinical Infectious Diseases, September 1, 2005.

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