Frequently Asked Questions
Though EPT has been legal in many states for several years, few EDs have systematically implemented policies to support it. Given the unfamiliarity many EM clinicians will have with EPT, we have answered a few common questions here.
Is it effective?
Is it legal?
Is it safe?
Is EPT a take-home medication or prescription?
Both of the medications most commonly dispensed for EPT, Azithromycin and Cefixime, are generally well tolerated.
Is it legal?
Who is EPT for?
EPT is intended for patients who are unable or unlikely to seek timely care. The preferred treatment is still if the partner seeks clinical services directly with a healthcare provider. When discussing options with the ED patient about treating their partner, use shared- decision making and consider some factors:
Partner is uninsured
Partner lacks a primary care provider
Partner faces significant barriers (such as transportation) to accessing clinical services
Partner is unwilling to seek timely care
EPT can be offered for sexual partners within the 60 days prior to ED encounter. If the last sexual encounter was more than 60 days prior, the most recent sexual partner should be treated.
There is no limit on how many partners can be provided treatment via EPT. EPT can be offered to some partners while the patient may opt for other partners strategies such as the patient referring the partner to a clinic.
If a partner is pregnant, every effort should be made to contact her for a referral to pregnancy services and/or pre-natal care, EPT is a last resort in this circumstance. Doxycline is contraindicated in pregnancy, but cefexime and azithromycin may still be used.
Who should not be offered EPT?
Check with your state and county health department as well as your hospital or health system for local guidelines. In general, EPT should not be used for the following:
Suspected child abuse or sexual assault
Concern for patient’s safety such as intimate partner violence
If the partner has a known allergies to the antibiotics
For patients who are co-infected with STIs other than chlamydia, gonorrhea or trichomoniasis (such as HIV, syphilis, hepatitis)
How does it work?
Some states require identifying information of the partner while in other states it can be prescribed without.
It can be conducted via prescription-EPT (index patient brings prescription to their partner for partner to fill), or medication-EPT (index patient brings medication to their partner). A study of patients treated in New York City found similar partner treatment rates via either method. (Oliver, Rogers, and Schillinger 2016)
Does the STI diagnosis need to be lab-confirmed?
Who pays for the EPT medication?
How do I know if the partner is allergic?
Is EPT a take-home medication or a prescription?
Why do the patient & partner need further care?