Thursday, May 27, 2010

Two for One Patient Care

An article in yesterdays St. Louis Post Dispatch (I can't link to it right now because I'm in Montreal for a conference and far from a computer) says that a new law has been passed in MONTH approving two-for-one treatments for sexual diseases.

What this new measure means us thatdoctors will prescribe antibiotics to the partners of people with STDs without ever examining them. This is the most ridiculous thing anybody can imagine. Pumping people who might turn out to be perfectly healthy full of dangerous drugs WITHOUT even seeing them. Of course, pharmaceutical companies will get a huge boost. Imagine how their customer pool will grow as a result of forcing many healthy people to ingest their drugs.

Anything that has to do with medications is completely out of control in the US.

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NancyP said...

1. The antibiotics aren't all that dangerous, unless you happen to have a rare allergic reaction.

2. For 30 to 60 years, patients have been treated with the same STD antibiotics*, and no significant resistance has developed. We have a lot of choices of antibiotics available.

*(Penicillin, minocycline or other tetracycline class, metronidazole.)

3. If you don't treat the partner, the patient will be reinfected with the STD. This has been shown again and again. Both men and women can be asymptomatic carriers.

4. It can be difficult to get an asymptomatic partner to come for a doctor's or physician assistant's exam. If the partner is a low-wage worker, partner's pay is docked for time spent going to the doctor. Partner may be too lazy to go. This way, a course of medications can be handed to partner. The public health officials are betting that at least some partners will take the meds. A large percentage of the clientele at typical city-run public health department STD clinics are poor, homeless or hard to track down, undocumented alien, sex worker, etc. This population can be difficult to treat, because they have other priorities, like eating, etc.

There are DNA tests for gonococcus and Chlamydia, and perhaps for Trichomonas (Trich is obvious in women and may be asymptomatic in men). Trich may also be observed swimming in a fresh prep for microscopy. There's a not-too-reliable serum screening test for syphilis, to be followed by a more specific antibody test.

Pagan Topologist said...

Those points are valid, NancyP. The issue has been being discused for half a century, I think. The issue that bothers me however, is that a significant number of people have more than one sexual partner. How would one decide which person to share the antibiotics with if he or she has three lovers, or five?