It’s a positive result—recommended treatments for standard infections
When a patient tests positive for chlamydia or gonorrhea, antibiotic treatment can offer a cure. However, though antibiotics have successfully treated gonorrhea for decades, in recent years the bacteria have developed resistance to nearly every drug used for treatment.1,2
In light of that, the Centers for Disease Control and Prevention (CDC) outlines the following treatment guidelines.1,2
CDC-recommended regimen for adults and adolescents
Azithromycin 1 g orally in a single dose
Doxycycline 100 mg orally 2 times a day for 7 days
Ceftriaxone 250 mg IM in a single dose PLUS azithromycin 1 g orally in a single dose
Alternative regimens can include one of the following:
If ceftriaxone is not available, it can be replaced with:
Visit the CDC’s website for more information on treating gonorrhea in special patient populations.
Visit the CDC’s website for more information on treating chlamydia in special patient populations.
*Because of the high prevalence of tetracycline resistance among Gonococcal Isolate Surveillance Project isolates, particularly those with elevated minimum inhibitory concentrations to cefixime, the use of azithromycin as the second antimicrobial is preferred.
It’s best to follow up—recommendations for further protection
Unfortunately, chlamydia and gonorrhea reinfection is common among patients. And because the risk of pelvic inflammatory disease (PID) and ectopic pregnancy is higher with each repeat infection, it’s crucial to follow these recommendations from leading health organizations.1-3
- Retest patients 3 months after treatment, regardless of whether they believe that their sex partners were treated
- Advise patients to abstain from sexual intercourse until all of their sex partners are treated
- Refer patients with current or recent STIs to high-intensity behavioral counseling, to address safe sex practices that can reduce disease transmission or reinfection
It’s another form of protection—Expedited Partner Therapy
Expedited Partner Therapy (EPT) is another way to help protect your female patients who have tested positive for chlamydia and gonorrhea. With EPT, you can provide medication for the sex partners of patients who have been diagnosed with chlamydia or gonorrhea without first examining them.4
EPT has been endorsed by leading health organizations, including the CDC, the American College of Obstetricians and Gynecologists, and the American Medical Association, which offers guidelines for ethical use.4-6
The CDC has concluded that EPT is a useful option to facilitate partner management, particularly for treatment of male partners of female patients with chlamydia or gonorrhea.4 However, the legal status of EPT varies from state to state, so it should be reviewed before administering EPT.7
Make STI screening part of your routine.
|Download It's Best to Test patient tear pad|
|Read "Can we talk? Four tips to discussing STIs with patients"|
|Review ICD-10-CM codes for gynecology and obstetrics|
|Read our Medicare National Coverage Determination Policy for STI screening|
|Learn about high-risk STI screening|
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- Centers for Disease Control and Prevention. 2015 sexually transmitted diseases treatment guidelines: chlamydial infections. Last reviewed June 4, 2015. Accessed May 2, 2019. www.cdc.gov/std/tg2015/chlamydia.htm.
- Centers for Disease Control and Prevention. 2015 sexually transmitted diseases treatment guidelines: gonococcal infections. Last reviewed June 4, 2015. Accessed May 2, 2019. www.cdc.gov/std/tg2015/gonorrhea.htm.
- US Preventive Services Task Force. Final recommendation statement: chlamydia and gonorrhea: screening. Last reviewed September 2014. Accessed May 2, 2019. www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/chlamydia-and-gonorrhea-screening.
- Centers for Disease Control and Prevention. Expedited Partner Therapy. September 2018. Accessed April 1, 2019. www.cdc.gov/std/ept/default.htm.
- American College of Obstetricians and Gynecologists. Expedited partner therapy. ACOG Committee Opinion No. 737. Obstet Gynecol. 2018;131:e190-3.
- American Medical Association. Expedited partner therapy: code of medical ethics opinion 8.9. Accessed May 2, 2019. www.ama-assn.org/delivering-care/ethics/expedited-partner-therapy.
- Centers for Disease Control and Prevention. Legal status of expedited partner therapy (EPT). Last reviewed November 9, 2018. Accessed May 2, 2019. www.cdc.gov/std/ept/legal/default.htm.