Expedited Treatment Cuts Gonorrhea Recurrence Rate

Doctors can reduce the risk of gonorrhea patients reacquiring the sexually transmitted disease by arranging to provide antibiotics to their sex partners, researchers said on Wednesday.

The “expedited treatment” technique, designed to replace the standard practice in which patients are asked to inform their partners about the infection so the partners can seek treatment, may also stem the spread of other sexually transmitted diseases, a study published in this week’s New England Journal of Medicine said. The technique is illegal in most states, because doctors are not supposed to give drugs to people they have not examined for fear it could spark a lawsuit if the patient has a bad reaction to the antibiotic. Where the practice was permitted, the chance a person would reacquire gonorrhea over the next few months fell to 3 percent under the expedited treatment system from 11 percent under the traditional notification system, the study found. About a million people in the United States are believed to have gonorrhea, but many do not know they are infected. “We’re hoping this study will create an impetus for other states and the CDC (Centers for Disease Control and Prevention) to really look at this and consider whether this should be the standard of care,” said chief study author Matthew Golden of the University of Washington in Seattle. “This should be something that’s acceptable for a provider to do,” Golden told Reuters. “Right now, we’re starting out with a system that is basically doing nothing for the vast majority of the cases.” Expedited treatment was permitted in California, Washington, Tennessee and Colorado, Golden said. Patients in expedited treatment were not always given drugs to deliver to their partners. In some cases, a patient received a prescription to hand to a partner or the drugs were mailed directly to the partner. The technique holds great promise for the improved control and prevention of sexually transmitted diseases, said Emily Erbelding and Jonathan Zenilman of Johns Hopkins University School of Medicine in an editorial in the Journal. But this form of treatment did not work well for people with chlamydia, an infection of the pelvis that can cause infertility and affects about 3 million people in the United States For chlamydia, the reinfection rate was 11 percent in cases when partners of patients got expedited treatment versus 13 percent for patients who were simply asked to encourage their partners to seek treatment. Golden said it appeared the success rate in the chlamydia portion of the study was low because the drugs given to fight the bacteria may not be as effective as doctors believe. (Source: Reuters Health, February 2005)