Feature

Most physicians lack on-site antimicrobials for treating gonorrhea and syphilis

Photo of Jeanne Marrazzo
Jeanne M. Marrazzo

Despite the trending rise in STDs in the United States, new data published in Emerging Infectious Diseases showed that most physicians do not have injectable antimicrobial drugs available on-site to treat gonorrhea and syphilis.

“The collective realization regarding how serious the STD resurgence is has really gained traction in the last year or 2 — not enough time to create the urgency that is needed to have an impact on the operations of providing comprehensive STD care,” said Infectious Disease News Editorial Board Member Jeanne M. Marrazzo, MD, MPH, director of the division of infectious diseases and C. Glenn Cobbs, MD, Endowed Professor in Infectious Diseases at the University of Alabama at Birmingham School of Medicine. “We need to catch up.”

The CDC’s annual STD report showed that around 2.4 million cases of chlamydia, gonorrhea and syphilis were reported in the United States in 2018, marking the fifth straight record-breaking year for STDs in the country.

“Over the past several years, CDC’s surveillance data has shown a dramatic increase in reported gonorrhea and syphilis cases in the U.S.,” William S. Pearson, PhD, MHA, FACE, a health scientist with CDC’s Division of STD Prevention, told Infectious Disease News. “Treating these infections as soon as possible is key in curbing the rise in sexually transmitted infections.”

Same-day treatment is optimal for treating STDs, Pearson and colleagues noted. In their study, they used the 2016 Physician Induction File of the National Ambulatory Medical Care Survey to assess the number of physicians treating STDs who had injectable antimicrobial drugs available on-site.

In total, 1,030 physicians completed the Physicians Induction File. According to results of the survey, 45.2% of office-based physicians indicated that they evaluate patients for STDs in their offices, and of these, 77.9% reported not having penicillin G benzathine on-site and 56.1% reported not having ceftriaxone, Pearson and colleagues reported.

“There may be barriers to having injectable antibiotics on-site. These barriers include the high costs of obtaining the antibiotics, storage requirements and a short shelf-life before the antibiotics are unfit to use and should be discarded,” Pearson explained.

The researchers noted that access to the drugs was higher in the South and among physicians in offices designated as patient-centered medical homes.

Marrazzo, who was not involved in the study, said that overall, the findings are “scary,” and the lack of available drugs increases the likelihood of STDs going untreated.

“Not having medications to treat these infections on hand means that patients have to be referred elsewhere to be treated. This increases the likelihood for patients to fall out of the care continuum, ie, not follow up for treatment, especially if they have no symptoms and feel fine,” she said. “This means not only might they suffer the consequences of untreated STD, but they remain infectious to their partners.”– by Caitlyn Stulpin

Disclosures: Marrazzo and Pearson report no relevant financial disclosures.

Photo of Jeanne Marrazzo
Jeanne M. Marrazzo

Despite the trending rise in STDs in the United States, new data published in Emerging Infectious Diseases showed that most physicians do not have injectable antimicrobial drugs available on-site to treat gonorrhea and syphilis.

“The collective realization regarding how serious the STD resurgence is has really gained traction in the last year or 2 — not enough time to create the urgency that is needed to have an impact on the operations of providing comprehensive STD care,” said Infectious Disease News Editorial Board Member Jeanne M. Marrazzo, MD, MPH, director of the division of infectious diseases and C. Glenn Cobbs, MD, Endowed Professor in Infectious Diseases at the University of Alabama at Birmingham School of Medicine. “We need to catch up.”

The CDC’s annual STD report showed that around 2.4 million cases of chlamydia, gonorrhea and syphilis were reported in the United States in 2018, marking the fifth straight record-breaking year for STDs in the country.

“Over the past several years, CDC’s surveillance data has shown a dramatic increase in reported gonorrhea and syphilis cases in the U.S.,” William S. Pearson, PhD, MHA, FACE, a health scientist with CDC’s Division of STD Prevention, told Infectious Disease News. “Treating these infections as soon as possible is key in curbing the rise in sexually transmitted infections.”

Same-day treatment is optimal for treating STDs, Pearson and colleagues noted. In their study, they used the 2016 Physician Induction File of the National Ambulatory Medical Care Survey to assess the number of physicians treating STDs who had injectable antimicrobial drugs available on-site.

In total, 1,030 physicians completed the Physicians Induction File. According to results of the survey, 45.2% of office-based physicians indicated that they evaluate patients for STDs in their offices, and of these, 77.9% reported not having penicillin G benzathine on-site and 56.1% reported not having ceftriaxone, Pearson and colleagues reported.

“There may be barriers to having injectable antibiotics on-site. These barriers include the high costs of obtaining the antibiotics, storage requirements and a short shelf-life before the antibiotics are unfit to use and should be discarded,” Pearson explained.

The researchers noted that access to the drugs was higher in the South and among physicians in offices designated as patient-centered medical homes.

Marrazzo, who was not involved in the study, said that overall, the findings are “scary,” and the lack of available drugs increases the likelihood of STDs going untreated.

“Not having medications to treat these infections on hand means that patients have to be referred elsewhere to be treated. This increases the likelihood for patients to fall out of the care continuum, ie, not follow up for treatment, especially if they have no symptoms and feel fine,” she said. “This means not only might they suffer the consequences of untreated STD, but they remain infectious to their partners.”– by Caitlyn Stulpin

Disclosures: Marrazzo and Pearson report no relevant financial disclosures.