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Patient-delivered partner treatment with azithromycin to prevent repeated Chlamydia trachomatis infection among women: a randomized, controlled trial.
Sexually Transmitted Diseases 2003;30(1):49-56.
Schillinger JA, Kissinger P, Calvet H, Whittington WLH, Ransom
RL, Sternberg JR, Berman SM, Kent CK, Martin DH, OH K, Handsfield HH,
Bolan
G, Markowitz LE, Fortenberry JD.
Abstract
BACKGROUND: Repeated infection with C trachomatis increases the risk for serious
sequelae: pelvic inflammatory disease, ectopic pregnancy, infertility, and
chronic pelvic pain. A substantial proportion of women treated for C trachomatis
infection are reinfected by an untreated male sex partner in the first several
months after treatment. Effective strategies to ensure partner treatment
are needed. GOAL: The goal of the study was to determine whether repeated
infections with C trachomatis can be reduced by giving women doses of azithromycin
to deliver to male sex partners. STUDY DESIGN: A multicenter randomized controlled
trial was conducted among 1,787 women aged 14 to 34 years with uncomplicated
C trachomatis genital infection diagnosed at family planning, adolescent,
sexually transmitted disease, and primary care clinics or emergency or other
hospital departments in five US cities. Women treated for infection were
randomized to one of two groups: patient-delivered partner treatment (in
which they were given a dose of azithromycin to deliver to each sex partner)
or self-referral (in which they were asked to refer their sex partners for
treatment). The main outcome measure was C trachomatis DNA detected by urine
ligase chain reaction (LCR) or polymerase chain reaction (PCR) by 4 months
after treatment. RESULTS: The characteristics of study participants enrolled
in each arm were similar except for a small difference in the age distribution.
Risk of reinfection was 20% lower among women in the patient-delivered partner
treatment arm (87/728; 12%) than among those in the self-referral arm (106/726;
15%); however, this difference was not statistically significant (odds ratio,
0.80; 95% confidence interval, 0.62-1.05; = 0.102). Women in the patient-delivered
partner treatment arm reported high compliance with the intervention (82%).
CONCLUSION: Patient-delivered partner treatment for prevention of repeated
infection among women is comparable to self-referral and may be an appropriate
option for some patients.