Episode Details

Episode 13: Treat the Partner(s): EPT The sun rises over the San Joaquin Valley, California, today is May 22, 2020. The COVID 19 pandemic has created a limited access to PPE in many health centers around the nation. Last week, Amazon also prioritized individual physicians for COVID-19 Supplies in providing much needed PPE for private practices. As a result, AAFP members and others working on the front lines of the pandemic have direct access to hundreds of items related to PPE, disinfectants, sanitizing products, diagnostic equipment and other materials. Way to go Amazon! Thank you for your business. Welcome to Rio Bravo qWeek, the podcast of the Rio Bravo Family Medicine Residency Program. We train residents and students to prevent illnesses and bring healing and hope to our community. Our mission: To Seek, Teach and Serve. Sponsored by Clinica Sierra Vista, Providing compassionate and affordable care to patients throughout Kern and Fresno counties since 1971. “Don't let success determine your happiness but instead let your happiness determine your success” –Salah Barhoum What a great quote. When you are happy, you are successful. We can see our happiness as the highest level of our success. Today our guest is a successful man, Joseph Gomes. He is a very entertaining guy with a great sense of humor and very intelligent, he is known by his friends as Joe. Welcome Dr Gomes. 1. Question number 1: Who are you? My name is Dr. Joseph Gomes, I am a father of 2 twin munchkins and R2 in the Rio Bravo Family Medicine Residency program in Bakersfield, CA. I was most recently bestowed the honor of being elected as one of the 3 chief resident physicians for the 2020-2021 academic year, which I am quite excited about. I completed my undergraduate degree, a BS in Biomedical Sciences at CSUS in Sacramento, CA and completed medical school via the American University of the Caribbean School of Medicine. I like playing with my kids and eating cupcakes. 2. Question number 2: What did you learn this week? I think if I were to attempt to list all that I learned, or forgot and was reminded of this past week we would run out of time. However, I am here to talk about a topic that I don’t think gets very much attention and that’s the subject of Expedited Partner Therapy, or EPT for short. I was exposed to this concept for the first time during my intern year and was shocked that it was something that wasn’t more well-known or discussed in the resident community. EPT Definition 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.” Patient’s sex partners from the past 60 days should be treated. EPT is for gonorrhea and chlamydia only. How would you write the prescription to treat gonorrhea if the treatment is IM Ceftriaxone? The current recommended treatment for gonorrhea is an IM dose of ceftriaxone AND a single dose of oral azithromycin 1 gram. The CDC recommends using cefixime and azithromycin in EPT. General Guidelines for EPT • Prescribe treatment for gonorrhea and chlamydia under the index patient’s name or their partners’ names. • Prescription should be accompanied by treatment instructions and warnings about taking medications • Gonorrhea health education and counseling • A statement advising that partners seek personal medical evaluation, particularly women with symptoms of PID. • No sexual intercourse for 7 days after treatment (ACOG, 2018) EPT is not recommended for: • MSM (high risk for coexisting infections, especially undiagnosed HIV infection) • Suspected child abuse • Sexual assault • Any other situation when patient safety is compromised • EPT has lower evidence in HSV, scabies, pubic lice, and trichomonas. 3. Question number 3: Why is that knowledge important for you and your patients? Per the Kern County Health Department webs