Expedited partner therapy
What is expedited partner therapy?
Expedited partner therapy (EPT) is when a healthcare provider prescribes or gives medication to the sexual partners of patients diagnosed with chlamydia or gonorrhea without an examination. EPT has been legal in Utah since 2009, when the Utah State Legislature passed House Bill 17. This bill does not mandate the use of EPT, it only gives providers the option of using EPT.
Patients and their partners depend on pharmacists to give out medications when they get a prescription from their provider. Pharmacists can help in the treatment process by giving patients information about medications, allergies, and explaining the importance of completing all prescribed treatment.
Key points for providers
- Providers can write a prescription for their patient’s sexual partner(s) with either the partner’s name and DOB, or it can read to the partner of (the patient’s name).
- Medications used to treat partners can only be billed to the partner’s insurance or paid for by the partner. The original patient’s insurance will not pay for it.
- Providers should give fact sheets to patients so they can give them to their partner(s). The fact sheets encourage partners to be evaluated by a healthcare provider and also give them information about STIs and the medication they are being offered (including the possibility of allergic reactions).
- Certain EPT medications can be given to pregnant partners, however, these partners should be referred to prenatal care and screened for syphilis and HIV. Pregnant partners should not take doxycycline (azithromycin 1g can be used as an alternative).
Current EPT recommendations
Gonorrhea
- 800 mg cefixime PLUS doxycycline 100 mg twice a day for 7 days if co-infection with chlamydia is not ruled out.
Chlamydia
- 100 mg doxycyline twice a day for 7 days.
When EPT is not recommended
- EPT is not always recommended for men who have sex with men (MSM) due to high rates of co-morbidities in this population. Shared clinical decision-making regarding EPT is recommended. MSM partners should be encouraged to visit a provider to have a comprehensive exam that includes extragenital (oral/anal) chlamydia and gonorrhea tests, in addition to syphilis and HIV testing.
- EPT is also not recommended for partners who have had an oral exposure for gonorrhea. Oral cefixime (Suprax) is less effective at treating pharyngeal gonorrhea than ceftriaxone. Partners should visit a provider for intramuscular (IM) treatment.
Information to discuss with patients and partners
- Explain possible allergic reactions to antibiotics and potential drug interactions.
- Inform patients and partners they should not engage in sexual activity for 7 days after the last partner's treatment.
- Advise partners to be examined by a medical provider for comprehensive STI testing.