Expedited Partner Therapy for Chlamydia trachomatis at the Community Pharmacy

The availability of more sensitive tests and single-dose antibiotic treatment regimens in the last 10 years has improved detection and treatment of uncomplicated Chlamydia trachomatis infection, but strategies for the notification and treatment of sexual contacts have remained largely unchanged. To prevent index patients from reinfection after resumption of sex with an untreated partner, it is important to initiate prompt treatment of sex partners. Traditional strategies for partner notification and treatment usually involve partner referral and attendance at a genitourinary medicine clinic; this approach is not popular among partners and is generally unsuccessful. One alternative strategy for antichlamydial treatment of sex partners is patient-delivered partner therapy, but this approach is not recommended because of the need for legislative changes for its implementation. A more feasible approach is expedited partner treatment (EPT) administered through pharmacies. A survey of community pharmacists in Lothian showed strong support for this approach for managing sexual contacts with uncomplicated chlamydia. However, EPT has not been evaluated in the United Kingdom. This pilot study evaluated sexual partner treatment of index cases with uncomplicated chlamydia infection at 90 community pharmacies over 18 months within the Lothian area. Between 2007 and 2009, selected health service centers provided a voucher for free treatment to index patients who had been treated for this infection to pass on to their sexual partner(s). The vouchers were redeemable at participating pharmacies for treatment with a single 1-g dose of azithromycin. One month after treatment, a survey of patient satisfaction was conducted by contact through telephone with women who had a voucher. The main study outcome was the proportion of vouchers that were redeemed. During the study, 577 vouchers were issued to chlamydia-positive index patients at mean age 22.9 (range: 15-47) years; 231 vouchers (40% response rate) were redeemed at the pharmacies within a median of 2 days after the index patients received them. Only 4% (15/375) of partners attended a clinic for treatment giving preference to the use of vouchers. Most of the index cases (87%, 48/55) reported that partners were satisfied by this treatment method. These findings demonstrate that EPT provides an approach to identification and treatment of sex partners of patients with uncomplicated chlamydia that is popular with sex partners. This approach may improve access to timely treatment, preventing reinfection through the resumption of sex with untreated partners.