Effectiveness of Chlamydia trachomatis expedited partner therapy in pregnancy

Zofkie, Amanda C.; Fomina, Yevgenia Y.; Roberts, Scott W.; McIntire, Donald D.; Nelson, David B.; Adhikari, Emily H.

doi:10.1016/j.ajog.2021.04.238

Cited by 3 publications

(8 citation statements)

References 16 publications

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“…18 The increase in offered EPT from 2019 to 2020 was likely influenced by a healthcare improvement initiative that was implemented at the system level mid-August 2019. 4,9 Because the intervention occurred halfway through the pre-COVID year, it is difficult to generalize the findings through the context of pre-COVID-19 and during COVID-19. Despite the increase in EPT, rates of repeat infections remained consistent between 2019 and 2020, which may be due to the large proportion of pregnant patients in both cohorts, as previous studies have conflicting findings between the effectiveness of EPT in the pregnant patient population versus the general female population.…”

Section: Discussion Primary/secondary Outcomesmentioning

confidence: 99%

“…The increase in offered EPT from 2019 to 2020 was likely influenced by a healthcare improvement initiative that was implemented at the system level mid-August 2019 4,9 . Because the intervention occurred halfway through the pre-COVID year, it is difficult to generalize the findings through the context of pre–COVID-19 and during COVID-19.…”

Section: Discussionmentioning

confidence: 99%

“…Several randomized trials demonstrated the benefit of prescribing partner treatment without medical evaluation. However, there are challenges in studying EPT in real-world settings, such as how to determine valid outcomes to measure and homing in on populations with the same risk factors for infection 4,5 …”

mentioning

confidence: 99%

“…However, there are challenges in studying EPT in real-world settings, such as how to determine valid outcomes to measure and homing in on populations with the same risk factors for infection. 4,5 A women's emergency unit setting within a safety-net county hospital poses a unique challenge related to the rapid rates of patient turnover leading to test results pending at discharge. A traditional combination nucleic acid amplification test for chlamydia and gonorrhea typically takes 1 to 4 days, whereas patients typically spend less than 12 hours in the emergency department (ED).…”

mentioning

confidence: 99%

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Effect of the COVID-19 Pandemic on Chlamydial Infection Treatment in Women Discharged From an Urban Safety-Net Emergency Unit

et al. 2022

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Background: Chlamydia is the most frequently reported sexually transmitted infection. COVID-19 exacerbated the challenges in treating and preventing new Chlamydia trachomatis (CT) infections. This study examined the impact of COVID-19 on treating CT-positive patients discharged from a safety-net women's emergency unit.Methods: This was a preretrospective and postretrospective cohort study.Chlamydia trachomatis-positive female patients seen in the women's emergency unit were evaluated. Patients discharged in 2019, the "pre-COVID-19" group, and those discharged in 2020, the "COVID-19" group, were compared. The primary outcome was CT treatment within 30 days, and secondary outcomes included prescription dispensation, repeat tests taken, and expedited partner treatment. A subgroup of patients discharged before treatment who entered a nurse-led follow-up program was also evaluated.Results: Of the 1357 cases included, there were no differences in successful 30-day treatment (709 of 789 [89.9%] vs. 568 of 511 [89.9%], P = 0.969) or repeat positive CT test (74 of 333 [22.2%] vs. 46 of 211 [21.8%]), P = 0.36) between pre-COVID-19 and COVID-19. However, the patients who picked up their prescription (196 of 249 [78.7%] vs. 180 of 206 [87.4%], P = 0.021) and those who were prescribed expedited partner therapy (156 of 674 [23.1%] vs. 292 of 460 [63.5%], P < 0.001) increased. Findings in the subgroup of patients who entered the follow-up program were consistent with those in the full cohort. Conclusions:The COVID-19 pandemic did not change treatment patterns of CT-positive patients in this safety-net women's emergency unit. However, patients were more likely to pick up their medications during COVID-19. Despite the perseverance of these programs through the pandemic, most patients are discharged before positive results, and a fair amount remain untreated.

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Section: Discussion Primary/secondary Outcomesmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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confidence: 99%

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Effect of the COVID-19 Pandemic on Chlamydial Infection Treatment in Women Discharged From an Urban Safety-Net Emergency Unit

et al. 2022

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“…All patients were treated with pabolizumab 2 mg/kg for 21 d for 5 courses, resulting in complete remission in 3 patients and death due to progression in 1 patient [ 16 ]. Two cases of very high-risk GTN treated with pabolizumab were reported with equally satisfactory results [ 17 ]. In this study, one patient treated with pabolizumab 200 mg (21 d course) was assessed to be in complete remission on imaging after 5 courses and entered clinical follow-up; the other patient had been treated for 3 courses at the time of writing and was also in complete remission, with no grade III-IV side effects.…”

Section: Immunotherapymentioning

confidence: 99%

Analysis of the Outcome of Treatment of Brain Metastases from Malignant Trophoblastic Tumours and Risk Factors for Prognosis during Pregnancy

Wang

Zhang

2022

Contrast Media & Molecular Imaging

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Temozolomide combined with whole-brain radiotherapy has good near-term efficacy and safety in the treatment of brain metastases from nonsmall cell lung cancer. In this study, we analyzed the risk factors for treatment and prognosis of brain metastases in gestational trophoblastic neoplasm (GTN) during pregnancy. Thirty-one patients with brain metastases were included in the study. All patients had a pathological diagnosis of primary lesions, including 23 adenocarcinomas, 7 squamous carcinomas, and 1 adenosquamous carcinoma, and had ≥3 intracranial metastases, controlled primary lesions (including resected primary lesions or unresectable primary lesions in partial remission (PR)/complete remission (CR) for ≥2 months) by cranial enhancement MRI and no extracranial metastases. Presence or control of extracranial metastases was for ≥2 months. The common adverse toxic effects were nausea, vomiting, neutropenia, and thrombocytopenia, but most patients tolerated them with symptomatic management.

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Expedited Partner Therapy: A Multicomponent Initiative to Boost Provider Counseling

Markowitz,

Ackerman-Banks,

Oliveira

et al. 2023

Sexual Trans Dis

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Background Expedited partner therapy prescription remains low and highly variable throughout the United States, leading to frequent reinfections with Chlamydia trachomatis and Neisseria gonorrhea. We examined provider counseling on expedited partner therapy before and after an electronic smart tools-based initiative. Methods In this quasi-experimental interrupted time series study, we implemented an initiative of electronic smart tools and education for expedited partner therapy in March 2020. We reviewed the records of patients with chlamydia and/or gonorrhea at an urban, academic obstetrics and gynecology clinic in the pre-implementation (March 2019-February 2020) and post-implementation (March 2020-February 2021) groups. Descriptive statistics and an interrupted time-series model were used to compare the percent of expedited partner therapy offered by clinicians to patients in each group. Results A total of 287 patient encounters were analyzed, 155 pre-intervention and 132 post-intervention. An increase in expedited partner therapy counseling of 13% (95% CI: 2-24%) was observed pre-intervention (27.1%; 42/155) versus post-intervention (40.2%; 53/132). Significant increases in provider counseling were seen for patients who were single (15%; 95% CI: 3-26%), ≥ 25 years old (21%; 95% CI: 6-37%), receiving public insurance (15%; 95% CI: 3-27%), seen by a registered nurse (18%; 95% CI: 4-32%), or seen for an obstetrics indication (21%; 95% CI: 4-39%). No difference was seen in patients’ acceptance of expedited partner therapy (p = 1.00). Conclusions A multi-component initiative focused on electronic smart tools is effective at increasing provider counseling on expedited partner therapy. Further research to understand patient perceptions and acceptance of expedited partner therapy is critical.

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Effectiveness of Chlamydia trachomatis expedited partner therapy in pregnancy

Cited by 3 publications

References 16 publications

Effect of the COVID-19 Pandemic on Chlamydial Infection Treatment in Women Discharged From an Urban Safety-Net Emergency Unit

Effect of the COVID-19 Pandemic on Chlamydial Infection Treatment in Women Discharged From an Urban Safety-Net Emergency Unit

Analysis of the Outcome of Treatment of Brain Metastases from Malignant Trophoblastic Tumours and Risk Factors for Prognosis during Pregnancy

Expedited Partner Therapy: A Multicomponent Initiative to Boost Provider Counseling

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