This document discusses using patient delivered partner therapy (PDPT) to manage sexual partners of patients diagnosed with chlamydia or gonorrhea. PDPT involves providing patients antibiotics or prescriptions to give to partners who may not seek treatment. The document outlines California laws allowing PDPT for chlamydia and gonorrhea, recommended antibiotics, guidelines for using PDPT, educating partners, and resources for implementation.

1. Using Patient Delivered Partner
Therapy (PDPT) for Partner
Management
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2. CFHC’s PDPT Trainings
• This is Part 2 of a 3-part series on PDPT
– Part 1: Background information about PDPT
– Part 2: Using PDPT for Partner Management
– Part 3: PDPT Law in California and
CFHC PDPT Guidelines
• For more information on PDPT:
http://
www.cdph.ca.gov/pubsforms/Guidelines/Documents/CA-STD-PDPT-Guidelines-1-
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3. What is PDPT?
 Patient delivered partner therapy (PDPT) is one
form of EPT.
 PDPT involves providing the index client with the
appropriate medication, information and
educational materials for sexual partners
exposed to the index client’s STI(s).
 PDPT is an alternative to traditional partner
notification methods for testing and treatment of
STIs.
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4. PDPT and California Law
 Chlamydia trachomatis (since 2001)
 Neisseria gonorrhoeae (since 2007)
 Because optimal treatment of syphilis
requires an injection, PDPT is not
recommended for syphilis.
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5. Antibiotics for PDPT
Chlamydia:
Azithromycin 1 gram
orally once
Gonorrhea:
Cefixime 400mg orally once
+
Azithromycin 1 gram
orally once
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6. Gonorrhea Treatment:
Dual Therapy Approach
Ceftriaxone 250 mg Azithromycin 1 gm orally in a single dose
PLUS OR
IM in a single dose
Doxycyline 100 mg orally twice daily for 7 days
OR
If ceftriaxone is not an option,
Cefixime 400 mg Azithromycin 1 gm orally in a single dose
PLUS OR
orally in a single dose Doxycyline 100 mg orally twice daily for 7 days
CDC 2010 STD Treatment Guidelines:
www.cdc.gov/std/treatment
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7. Neisseria gonorrhoeae Isolates with CDC "Alert" Values or
Decreased Susceptibility to Cephalosporins in Five
California STD Clinics, 1987-2011
*
*
* Cefixime was dropped from testing panel in 2007 and reinstated in
2009;
Cefpodoxime was added to testing panel in 2009
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8. PDPT for Gonorrhea
 Not first line of partner management for
GC.
 Other aspects of PDPT dispensing and
counseling remain the same.
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9. When Should PDPT Be Used?
 Only use PDPT if partner(s) are unable to or
are unlikely to seek care.
 PDPT should not be a substitute for clients
returning with their partners for treatment.
 Every attempt should be made to bring
partners in for clinical evaluation and
treatment.
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10. Which Partners Can Get PDPT?
 All sex partners within previous 2 months
of client’s symptoms or diagnosis.
 If client had no sex partners within last 60
days, then most recent sex partner(s).
 PDPT is appropriate for both male and
female partners.
 There is no limit to # doses that can be
distributed for sex partners.
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11. Educational Materials with PDPT
 Written informational materials directed to
the partner should ALWAYS accompany
PDPT medication.
 Materials should discuss:
 Medication instructions
 Warnings and referrals
 Concern about pelvic inflammatory disease
(PID) in female partners.
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12. Risks of PDPT
 As with any treatment, there is always a
risk of adverse reactions to medications.
 Minimal risks associated with single dose
azithromycin, and cefixime.
 PDPT may compromise the quality of care
for partners, especially if the partner is co-
infected with another STI or has
undiagnosed HIV infection.
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13. When Should PDPT NOT Be
Used?

Do not use PDPT with clients co-infected with
STDs that are not treatable by PDPT
medications.

Do not use PDPT in cases of suspected child
abuse, sexual assault, or cases where the
client’s safety is in question.

Do not use PDPT when it is known that
partners have severe allergies to antibiotics.
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14. Key PDPT Counseling Messages
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15. Key PDPT Counseling Messages
1. Partners should seek a complete STD
evaluation as soon as possible, regardless
of whether they take the medication.
2. Partners should read the informational
material very carefully before taking the
medication.
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16. Key PDPT Counseling Messages
3. Partners who have allergies to antibiotics
or who have serious health problems
should not take the medications and
should see a healthcare provider.
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17. Key PDPT Counseling Messages
4. Partners who have symptoms of a more
serious infection (e.g., pelvic pain in
women, testicular pain in men, fever in
women or men) should not take the PDPT
medications and should seek care as soon
as possible.
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18. Key PDPT Counseling Messages
5. Partners who are or could be pregnant
should seek care as soon as possible.
6. Clients and partners should abstain from
sex for at least seven days after treatment
and until seven days after all partners have
been treated, in order to decrease the risk
of re-infection.
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19. Resources for PDPT
Implementation
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20. IPP Guidance & Toolkit
CARDEA Region IX Guidance and Toolkit for
the Use of Expedited Partner Therapy and
Retesting at Three Months To Prevent and
Detect Chlamydia and Gonorrhea
Reinfections
http://www.cardeaservices.org/projects/documents/R9_
EPT_Retesting_Nov08.pdf
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21. CFHC Patient Education Materials
Samples of the chlamydia PDPT patient education
handouts in English, Spanish, Chinese, and
Vietnamese are available for free on the CFHC
website, as well as gonorrhea PDPT patient
education handouts in English and Spanish.
http://www.cfhc.org/Resources/SamplesFile/sexually
-transmitted-disease.html
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22. Questions?
For CFHC PDPT Program information, please
contact:
Aileen Barandas MSN, NP
STD Programs Director
barandasa@cfhc.org
510.486.0412 ext 2334
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23. Medical and scientific consultation for this
webcast was provided by the California
Department of Public Health, STD Control
Branch
For more information, please visit
www.std.ca.gov
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