Extend STD treatment beyond patients, say ob-gyns

NEW YORK Fri Aug 26, 2011 6:59pm EDT

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NEW YORK (Reuters Health) - American obstetrician-gynecologists are pushing to extend their reach to the sexual partners of women treated for gonorrhea or Chlamydia.

There is a good chance those men are infected, too, although they may not experience symptoms of the STD, the doctors say.

Giving an infected woman antibiotics or a prescription to take to her partner would help cut the chance that she catches the bug anew after she's been treated, the American College of Obstetricians and Gynecologists (ACOG) said earlier this week in a statement.

The concept, known as "expedited partner therapy," has been backed for years by other medical associations as well as the U.S. Centers for Disease Control and Prevention (CDC).

Some doctors are already treating people this way, but it remains illegal in eight U.S. states and only "potentially allowable" in 15 others, according to the CDC. In those states where doctors aren't permitted to use expedited partner therapy, ACOG encourages them to advocate for it.

According to the group, whose statement appears in the journal Obstetrics & Gynecology, there are some concerns about giving drugs to people who haven't been examined by a doctor.

Those include not being able to make sure they know about side effects, such as diarrhea and rare allergic reactions, and possibly fueling the growth of drug-resistant bacteria in case they aren't infected after all. Still, ACOG says those risks are outweighed by the benefits of potentially curbing STDs.

That assessment is echoed by Dr. Myron Cohen, who heads the division of infectious diseases at the University of North Carolina at Chapel Hill.

"To treat the infected person and not the partner creates an impossible situation," Cohen, who is not affiliated with ACOG, told Reuters Health.

"From a social-justice point of view, doing nothing with the partner makes no sense."

He acknowledged that you might end up giving antibiotics to healthy people, but added that the harms are minimal and that in most cases a short course of antibiotics won't breed resistance.

"Over-treating has to be weighed against no partner management," Cohen said.

"I think clearly over-treatment is better." Chlamydia and gonorrhea are among the most common STDs.

The CDC estimates that there are 2.8 million chlamydia infections every year in the U.S., while more than 700,000 Americans get gonorrhea.

Some research has shown that expedited partner therapy may slash the number of re-infections, although one recent study at a university-based family planning clinic found no such effect.

Still, one Scottish study from last year showed that vouchers for free medication helped sexual partners of people treated for chlamydia get treatment too. In the U.S., Cohen said STD clinics give out antibiotics for free, and that this would likely also be the case when treating partners remotely.

SOURCE: bit.ly/o6M3i4 Obstetrics & Gynecology, online August 22, 2011.

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