Expedited partner therapy for sexually transmitted infections.

Abstract

In 2006, the Centers for Disease Control and Prevention recommended Expedited Partner Therapy (EPT) as a clinical option for assuring treatment of sex partners of persons infected with sexually transmitted infections. In this review, we provide an update on research, evaluation and efforts to increase EPT coverage. We also attend to EPT for gonorrhea in the context of antimicrobial resistance. Controlled trials in the United States and United Kingdom have presented increasing variety in intervention approaches. Trials and program evaluations typically demonstrate increased partner treatment rates, although only some studies show reductions in follow-up infection rates. Coverage has increased substantially, with over 30 states permitting EPT for chlamydial infection, gonorrhea, or both. The prospect of cephalosporin-resistant gonorrhea, however, raises the prospect that EPT may become less feasible as a partner treatment approach for gonorrhea patients. Clinicians should continue to be aware of the importance of partner managements for STD-infected patients, with EPT being an evidence-based intervention in that respect. The variety in EPT models provides alternatives that may suit some practices and venues. For clinicians seeing gonorrhea patients, effective counseling models - enhanced patient referral - should be closely examined in case oral treatment for gonorrhea becomes infeasible.