By Josh Faucher, MD, JD // Edited by Michael Barrie, MD
A 24 year-old male presents to your rural ED’s fast-track area with purulent penile discharge and dysuria. These have been present for the past week, and he recently began intercourse with a new female sexual partner. They have not used barrier contraception. He denies hematuria, fevers, genital lesions, or other associated symptoms; his physical exam is within normal limits other than purulent penile discharge. Rapid urine testing is positive for Neisseria gonorrhea infection; the patient is treated empirically in the ED with one-time doses of ceftriaxone and azithromycin. He denies any other recent sexual partners. The patient’s sexual partner works full time but is uninsured, and in your rural area there are no local STD clinics that are easily accessible for partner follow-up. Your patient asks if he can have a prescription to conveniently treat possible infection in his female partner at home, saving the time and cost of an additional ED visit or delayed outpatient follow-up. Can you provide the sexual partner any treatment without seeing her directly as a patient?