Concurrent patient-partner treatment in pregnancy:  an alternative to expedited partner therapy?
BACKGROUND
Concurrent patient-partner treatment (CPPT) is the provision of treatment to the index patient and their sexual partner(s) and appears to be an effective method of preventing repeat sexually transmitted infections. The objectives of the study were to determine whether CPPT reduces the prevalence of a positive test of cure (TOC) for chlamydia and/or gonorrhea infection in pregnant women.


METHODS
We conducted an observational cohort study of 241 pregnant women aged 15 to 40 years diagnosed with chlamydia and/or gonorrhea receiving prenatal care at an urban teaching hospital. Pregnant women and their sexual partner(s) received CPPT consisting of azithromycin and/or cefpodoxime for treatment of chlamydia and/or gonorrhea infection, respectively, or patient referral consisting of an antibiotic prescription to the pregnant woman and advice for partner screening and therapy. Odds ratios (ORs) and survival estimates were calculated by χ or Fisher exact test, multivariable logistic regression, and Kaplan-Meier.


RESULTS
Forty-five pregnant women with chlamydia and/or gonorrhea received CPPT and were less likely to have a positive TOC (OR = 0; P < 0.001) and repeat positive chlamydia infection (OR = 0; P = 0.12) compared with 196 women that were treated and counseled on the patient referral treatment strategy for their sexual partners. CPPT shortened the median time to cure (4.4 weeks, standard deviation = 2.3) versus standard patient referral (5.1 weeks, standard deviation = 5.2). There were no repeat positive chlamydia infections in the CPPT group compared with 19 (18.1%) in the patient referral group.


CONCLUSIONS
CPPT decreased the prevalence of a positive TOC for chlamydia infection among pregnant women.
Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, CA 94105, USA. mmejeo@globalhealth.ucsf.edu
Okeoma
O
Mmeje
Jenell S
JS
Coleman
D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D017963:Azithromycin / Q000008:administration & dosage; D015296:Ceftizoxime / Q000008:administration & dosage / Q000031:analogs & derivatives; D002690:Chlamydia Infections / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control*; D002692:Chlamydia trachomatis / Q000472:pathogenicity*; D015331:Cohort Studies; D005260:Female; D006069:Gonorrhea / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D008297:Male; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control*; D011295:Prenatal Care; D015995:Prevalence; D012747:Sexual Partners; D014481:United States / Q000453:epidemiology; D000097623:Cefpodoxime
D000900:Anti-Bacterial Agents; D017963:Azithromycin; D015296:Ceftizoxime; D000097623:Cefpodoxime