According to a study conducted by scientists in New Orleans and elsewhere, a woman is more likely to avoid a second case of an STD if she gives medicine, rather than advice, to her sexual partners. The study supports a system called patient-delivered partner treatment, which allows for doctors to provide medicine for people they have not directly examined.

The study tracked nearly 1,800 women with chlamydia. Chlamydia can be treated with one dose of azithromycin, sold under the brand name Zithromax. About half the study participants received the drug for their partners; the others were asked to urge partners to be treated. Women who were more likely to visit clinics for such purposes as regular checkups, pelvic examinations and family planning information were picked for the study, the authors said. They found that women who provided their partners with azithromycin were 20 percent less likely to be reinfected. However, the authors noted that as many as one-fifth of the women contracted the disease again within six months of treatment.

A previous investigation of this method by Tulane University epidemiologist Patricia Kissinger, who oversaw the New Orleans portion of the current study, prompted California lawmakers to change that state's law, allowing doctors to prescribe extra doses of antibiotics for sex partners of patients. Similar legislative changes would be necessary in Louisiana and other states because doctors must examine patients before dispensing medicines. This seems unlikely because a physician could be sued if the unseen recipient had a bad reaction to the drug, said Dr. Brobson Lutz, medical spokesperson for the Orleans Parish Medical Society. "This seems like an important public health approach, but because of legal concerns, I doubt that it will transplant to the private-practice community with much enthusiasm," Lutz said.

Dr. Jeff Klausner, head of the STDs unit in the San Francisco Department of Health, reviewed Kissinger's earlier study on patient-delivered therapy and promptly urged the California State Assembly to pass a bill letting doctors give extra medicine to chlamydia patients. That law took effect two years ago. Klausner added that no California clinics have received reports of adverse reactions since patient-delivered treatment became legal.

The full report, "Patient-Delivered Partner Treatment with Azithromycin to Prevent Repeated Chlamydia Trachomatis Infection Among Women: A Randomized, Controlled Trial," was published in Sexually Transmitted Diseases (2003;30(1):49-56).

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