Patient and Partner Education

Many state health departments have prepared materials regarding EPT to assist in both the patient and partner's understanding of the diagnosis and treatment. Please refer to your local resources for specific pdfs for distribution.

Patient and Partner information sheets should provide the following guidance:

• A description of the STI for which the EPT is being provided

• STI education and information

• The name and possible side effects of the medication

• An outline of relevant contraindications

• Advice that a full evaluation for STIs is preferred

• Guidance that a partner should seek medical attention for any symptoms suggestive of complications (e.g., testicular pain in men and pelvic or abdominal pain in women).

• Instructions to abstain from intercourse until 7 days after both patient and partner have completed treatment

• Provide contraceptive information, if indicated

• Encourage consistent and correct condom use to prevent STDs

• A list of locations where partners can obtain no- or low-cost evaluation for STIs

• Recommendation for patient and partner to get tested / retested 3 months after treatment

Precautions:

Patients and partners should be cautioned to be aware of symptoms and histories that may put them at risk for STI co-infections or more serious sites or sequelae of STIs. The following are examples of precautions that may be included in information sheets:

• Women: If you have lower belly pain, pain during sex, vomiting, or a fever, do not take this medication. You should see a doctor to be certain you do not have Pelvic Inflammatory Disease (PID). PID can be serious and may lead to infertility, pregnancy problems, or chronic pelvic pain.

• Pregnant Women: It is very important for you to see a doctor to get pregnancy services and pre-natal care. The antibiotics for EPT are safe for pregnant women, but you still need to see a doctor as soon as possible. It is also important to note that doxycycline is an alternative therapy for chlamydia treatment, but pregnant women should not take it.

• Men: If you have pain or swelling of your testicles, or have a fever, do not take this medication. See a doctor as soon as possible.

• Men who have sex with men: There are high rates of syphilis and HIV in men who have sex with men. Many men with gonorrhea and/or chlamydia could also have syphilis and/or HIV and not know it. If you are a man who has sex with other men, it is very important that you see a healthcare provider and get tested for HIV and syphilis.

Do not take azithromycin if you have had an allergic reaction to: azithromycin (Zithromax), erythromycin, clarithromycin (Biaxin), or telithromycin

Do not take metronidazole (Flagyl) if you are allergic to metronidazole.

Do not take doxycycline (Vibramycin) if you are allergic to tetracyclines or doxycycline.

Do not take cefixime if you have an allergy to cephalosporins (Ceftin, Cefzil, Keflex, Omnicef) or a life-threatening allergy to penicillin. If you do not know if you have an allergy, call your doctor or pharmacist before taking this medication.

Contact your doctor before taking these medications if you have:

· Kidney disease

· Liver disease

· Heart Disease

· Colitis

· Other stomach problems

If you take other prescription medication(s), talk to your doctor and pharmacist before taking these medications.

Check with your state health department for the most up to date guidance, as treatment regimens change depending on local susceptibilities and CDC recommendations such as the recent change to gonorrhea treatment in December 2020.

The following guidelines are specific for Michigan State and are provided as an example:

• Guidance for Health Care Providers: Expedited Partner Therapy (Michigan Department of Health and Human Services, 2021)

• Expedited Partner Therapy: Information Sheet for Patients and Partners (Michigan Department of Health and Human Services, 2021)

• STI Expedited Partner Therapy Treatment Guidelines (Michigan Department of Health and Human Services, 2021)