Doctor's Diagnosis: Chlamydia

CHLAMYDIA

Even though chlamydia is relatively easily to diagnose and treat, I always found dealing with chlamydia patients extremely frustrating. Let me explain.

Chlamydia is a very common bacterial sexually transmitted disease (STD), with more than a million new cases each year in the United States. It can be easily spread by vaginal, oral or anal sex.

Patients with chlamydia may have a discharge from their penis or vagina and a burning sensation when they urinate, or they may have no symptoms at all. Especially in females, untreated infections can lead to long-term problems, such as chronic pelvic pain, infection of the uterus and fallopian tubes, and possibly even sterility.

If treatment with antibiotics is simple and effective, what’s the catch? I used to see the same problem over and over again. For the antibiotic treatment to be effective, both the patient and any sex partner(s) need to be treated simultaneously. Otherwise, the patient is cured but eventually will reacquire the infection from the partner. This is known as the “ping-pong effect” as the infection is continuously passed back and forth. Many patients are very reluctant to bring in their partners to be treated for a sexually transmitted disease. When I was treating patients with chlamydia, the law was clear: No antibiotic prescription could be given to a patient unless the patient had been evaluated in person. Hence, we would end up seeing the same patients come in over and over again, with the same problem.

Now, New York State has addressed this dilemma by adapting an “Expedited Partner Therapy” (EPT) program. If a patient is diagnosed with chlamydia, the health care provider can not only treat the patient but also prescribe an antibiotic for a partner, even though the partner has not been examined.

It is hoped that this will increase the chances of both partners being treated at the same time, thus eliminating the “ping-pong effect” and eliminating the frustration of both patients and health care providers.

If any of you have experience with the EPT program, I’d like to hear

Dr. Stephen Picca of Massapequa is Board Certified in both Internal Medicine and Anesthesiology. He is retired from practice. Questions and comments can be sent to Dr. Picca at health@newsday.com.