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At least nineteen Illinois cases are now linked to the reports of elevated lead levels in recalled cinnamon applesauce pouches. To learn more about the recall, go to https://www.cdc.gov/nceh/lead/news/lead-poisoning-outbreak-linked-to-cinnamon-applesauce-pouches.html. If you or a family member consumed this product, consult your health care provider.

Expedited Partner Therapy (EPT)

Guidance for Health Care Professionals in Illinois

EPT is the clinical practice of treating the sex partners of patients diagnosed with chlamydia or gonorrhea by providing prescriptions or medications to the patient to take to his/her partner without the health care provider first examining the partner. EPT is an effective treatment option to increase the likelihood of treatment for sex partners, thus reducing re-infection rates and overall sexually transmitted infections (STI) rates in a community.

Practical Guidelines for Prescribing EPT

The following are suggestions for clinicians to consider taking when prescribing or providing EPT, not official IDPH protocols or standing orders.

Option 1

Include all doses in one prescription issued in the patient’s name.

Patient can request 2 containers of medication so easier for patient to give one to partner.

Submit ONE prescription for patient and partner/s.

Example:

Jane Doe,  Doxycycline 100 mg. One tab PO BID X 7 days for patient and 1 tab PO BID x 7 days for partner, Dispense #28. In “Notes to pharmacist” section, write “EPT” or “expedited partner treatment.”

Option 2

Submit multiple electronic prescriptions in your patient’s name, except in prescription for the partner note “EPT” in the “Notes to pharmacist” section.

Example: 

First Rx: Jane Doe, Doxycycline 100mg. 1 tab POD BID x 7 days Dispense #14

Second Rx: Jane Doe,  Doxycycline 100mg. 1 tab POD BID x 7 days Dispense #14.  In “Notes to pharmacist” section write “EPT” or “for partner treatment.”

EPT has been legal in Illinois since January 2010.

The law protects prescribing clinicians from civil and professional liability, except for willful and wanton misconduct. Health care professionals (defined as physicians, physician assistants, advanced practice nurses) who make a clinical diagnosis of chlamydia, gonorrhea, or trichomoniasis may prescribe, dispense, furnish, or otherwise provide antibiotics to the infected person’s partner(s) without physical examination of the partner(s).  See EPT Law on the right under Laws & Rules.

EPT is ideal for the partner(s) who is unlikely or unable to present for comprehensive medical care. The health care professional should provide patient counseling as well as written materials (see below) to be given to the partner by the patient.

Why use EPT? It works!

  • It is considered the standard of care and is endorsed by the Centers for Disease Control and Prevention (CDC) and other professional organizations (listed below).
  • It is proven to reduce re-infection rates and possible health complications due to untreated STIs.
  • It is an effective tool to combat the rising STI rates.
  • It is a useful option to facilitate partner treatment.
  • It is an effective option for partners who are unlikely to seek treatment, however clinical evaluation is still preferred.
  • It allows the patient to deliver either prescription or medications along with an informational fact sheet to their partner(s).

EPT has the support of professional organizations

  • American Medical Association, since 2006
  • American Bar Association, since 2008
  • Society for Adolescent Health and Medicine, since 2008 (Co-signed by the American Academy of Pediatrics, 2009)
  • National Association of City and County Health Officials, since 2009
  • American Congress of Obstetricians and Gynecologists (ACOG) Committee Opinion, since 2011
  • National Coalition of STD Directors testimony, since 2013

Eligible Partners

Eligible partners include sex partners (of patients diagnosed with chlamydia, gonorrhea, and/or trichomoniasis) exposed within the previous 60 days and unlikely or unable to seek medical care. A comprehensive clinical evaluation is always the first choice for pregnant women and gay, bisexual, non-binary, and transgender women.

Recommended EPT Medications Given to Sex Partners Based Upon Index Patient’s Diagnosed Infection

  • Chlamydia infection
    • Doxycline 100mg orally twice a day for seven days.
    • Azithromycin (Zithromax) tablets 1g orally (500mg tablets x2)
  • Gonorrhea infection
    • Cefixime (Suprax) 800mg orally once.
  • Trichomoniasis infection
    • Males: Metronidazole 200g orally once.
    • Females: Metronidazole 500mg orally twice a day for seven days.

EPT Facts for Patients

  • Patients and partners should not engage in sexual activity for seven days following completion of EPT.
  • Allergic reactions, although quite rare, may occur.
  • Encourage patients to have partners seen by a medical professional.
  • Provide informational fact sheets to be given to the partner by the patient.
  • It is recommended that any patient diagnosed with chlamydia, gonorrhea, and/or trichomoniasis infection be re-tested in three months to evaluate for possible re-infection.

Illinois Reporting of EPT

Health care providers can report EPT doses given to clients with chlamydia or gonorrhea infections at time of STI reporting either online through I-NEDSS or on the STI Morbidity Report Form. Reported use of EPT increased 151% by health care providers treating residents of Illinois who tested positive with chlamydia/gonorrhea from 2010 to 2016 (508 doses among 60 different counties to 1,275 doses among 90 different counties). Trichomoniasis was added to the EPT law as of January 1, 2022.

Resources

Laws & Rules

Publications

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