Empirical treatment of asymptomatic contacts of gonorrhoea: patient views
Ruthy McIver
A D , Sheina Low B , Rick Varma A C , Tobias Vickers A C and Anna McNulty A B
A Sydney Sexual Health Centre, Nightingale Wing, Sydney Eye Hospital, 8 Macquarie Street, Sydney, NSW 2000, Australia.
B School of Public Health and Community Medicine, UNSW, High Street, Kensington, NSW 2052, Australia.
C The Kirby Institute, UNSW, High Street, Kensington, NSW 2052, Australia.
D Corresponding author. Email: ruthy.mciver@health.nsw.gov.au
Sexual Health 17(5) 462-466 https://doi.org/10.1071/SH20072
Submitted: 30 April 2020 Accepted: 9 September 2020 Published: 13 November 2020
Abstract
Background: The prevalence of Neisseria gonorrhoeae (gonorrhoea) in sexual contacts of gonorrhoea has not been established, but limited data suggest that the majority of contacts are not infected. Contacts of gonorrhoea who receive empirical treatment at the point of testing may receive unnecessary antimicrobial treatment for an infection that is known to have multidrug resistance. This study evaluated patient acceptability of non-empirical treatment.? Methods: We conducted an anonymous cross-sectional survey of patients attending sexual health centres in New South Wales, Australia, on the acceptability of empirical and non-empirical treatment models and patients’ concerns about antimicrobial resistance. Results: Most of the 823 survey participants were willing to wait for treatment until their results were reported; 77% and 53% would agree to wait for treatment if results were available in 2 and 7 days respectively. Participants were less likely to agree to non-empirical treatment if they lived in regional and remote areas compared with those in a major city (odds ratio (OR) 0.5; 95% confidence interval (CI) 0.35–0.73). Most participants (70%) were worried about infections becoming resistant to antibiotics, with heterosexual men and women being less likely than gay and bisexual men to be worried (heterosexual men: OR 0.64, 95% CI 0.44–0.94; women: OR 0.64 95%, CI 0.44–0.92). Conclusions: Non-empirical treatment was acceptable to most participants, but patient preference, ability to return for treatment and timeliness of results are factors that should inform individual treatment decisions.
Keywords: antimicrobial stewardship, models of care, treatment guidelines.
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