{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T06:36:18Z","timestamp":1776321378801,"version":"3.50.1"},"reference-count":20,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>In 2019, informed by favourable patient and provider acceptability surveys and concerns about antimicrobial resistance, Sydney Sexual Health Centre stopped routinely providing empirical antibiotic treatment to asymptomatic contacts of<jats:italic>Chlamydia trachomatis<\/jats:italic>(chlamydia) and<jats:italic>Neisseria gonorrhoea<\/jats:italic>(gonorrhoea). We aimed to assess if this policy change had any negative impact on patient outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective file review of people who presented as asymptomatic contacts of chlamydia and gonorrhoea cases before and after the policy change was conducted. Data on infection type, test results and treatment were extracted. For contacts who tested positive and were treated non-empirically, additional data were reviewed including sexual activity and symptom or complication development between testing and treatment, time from testing to notification and treatment and loss to follow-up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 1194 asymptomatic sexual contacts of chlamydia or gonorrhoea, most tested negative to both infections (814, 68%). All contacts with a positive result who were not treated empirically were notified of their result and 173 (99%) were treated within a mean time of 5 days. More contacts were overtreated in 2018 (n=355, 58%) under the empirical treatment model compared with 2019 (n=58, 11%, p\u22640.001). There was no significant difference in the proportion of contacts who tested positive and were treated (p=0.111) or developed symptoms (p=0.413) before and after the policy change and no contacts who were treated non-empirically developed complications of pelvic inflammatory disease, epididymitis or proctitis between testing and treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In this population, a switch from empirically treating all asymptomatic contacts to treating only those who tested positive significantly reduced antibiotic overuse with minimal adverse outcomes. Our findings support results-directed treatment for asymptomatic sexual contacts of chlamydia and gonorrhoea.<\/jats:p><\/jats:sec>","DOI":"10.1136\/sextrans-2021-055382","type":"journal-article","created":{"date-parts":[[2022,4,5]],"date-time":"2022-04-05T17:25:31Z","timestamp":1649179531000},"page":"30-34","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Non-empirical management of asymptomatic chlamydia and gonorrhoea reduces unnecessary antibiotic use fivefold: a before and after study"],"prefix":"10.1136","volume":"99","author":[{"given":"Rafeeqah","family":"Rasul","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3206-0046","authenticated-orcid":false,"given":"Ruthy","family":"McIver","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prital","family":"Patel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8098-3718","authenticated-orcid":false,"given":"Rosalind","family":"Foster","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"McNulty","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,4,5]]},"reference":[{"key":"2023101000001313000_99.1.30.1","unstructured":"Chlamydia - Australian STI Management Guidelines. Available: http:\/\/www.sti.guidelines.org.au\/sexually-transmissible-infections\/chlamydia [Accessed 02 Jul 2021]."},{"key":"2023101000001313000_99.1.30.2","unstructured":"Gonorrhoea - Australian STI Management Guidelines, 2021. Available: http:\/\/www.sti.guidelines.org.au\/sexually-transmissible-infections\/gonorrhoea"},{"key":"2023101000001313000_99.1.30.3","doi-asserted-by":"crossref","first-page":"1251-7","DOI":"10.1111\/jdv.13181","article-title":"2015 European guidelines for the management of partners of persons with sexually transmitted infections","volume":"29","author":"Tiplica","year":"2015","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"2023101000001313000_99.1.30.4","doi-asserted-by":"publisher","DOI":"10.1177\/0956462415615443"},{"key":"2023101000001313000_99.1.30.5","doi-asserted-by":"publisher","DOI":"10.1177\/0956462419886775"},{"key":"2023101000001313000_99.1.30.6","doi-asserted-by":"publisher","DOI":"10.1177\/2042098614554919"},{"key":"2023101000001313000_99.1.30.7","unstructured":"Growing antibiotic resistance forces updates to recommended treatment for sexually transmitted infections, 2021. Available: https:\/\/www.who.int\/news\/item\/30-08-2016-growing-antibiotic-resistance-forces-updates-to-recommended-treatment-for-sexually-transmitted-infections"},{"key":"2023101000001313000_99.1.30.8","doi-asserted-by":"publisher","DOI":"10.1258\/0956462042395113"},{"key":"2023101000001313000_99.1.30.9","doi-asserted-by":"publisher","DOI":"10.1071\/SH19091"},{"key":"2023101000001313000_99.1.30.10","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0000000000001234"},{"key":"2023101000001313000_99.1.30.11","doi-asserted-by":"publisher","DOI":"10.1177\/0956462418799181"},{"key":"2023101000001313000_99.1.30.12","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0b013e318151497d"},{"key":"2023101000001313000_99.1.30.13","first-page":"791","article-title":"Pelvic inflammatory disease","volume":"85","author":"Gradison","year":"2012","journal-title":"Am Fam Physician"},{"key":"2023101000001313000_99.1.30.14","doi-asserted-by":"publisher","DOI":"10.1258\/095646207782212351"},{"key":"2023101000001313000_99.1.30.15","doi-asserted-by":"publisher","DOI":"10.1071\/SH19165"},{"key":"2023101000001313000_99.1.30.16","doi-asserted-by":"publisher","DOI":"10.1071\/SH20072"},{"key":"2023101000001313000_99.1.30.17","doi-asserted-by":"publisher","DOI":"10.1177\/0956462419879615"},{"key":"2023101000001313000_99.1.30.18","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0000000000000471"},{"key":"2023101000001313000_99.1.30.19","unstructured":"Multi-drug resistant gonorrhoea, 2021. Available: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/multi-drug-resistant-gonorrhoea"},{"key":"2023101000001313000_99.1.30.20","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(20)30154-7"}],"container-title":["Sexually Transmitted Infections"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/sextrans-2021-055382","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,10]],"date-time":"2023-10-10T07:01:37Z","timestamp":1696921297000},"score":1,"resource":{"primary":{"URL":"https:\/\/sti.bmj.com\/lookup\/doi\/10.1136\/sextrans-2021-055382"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4,5]]},"references-count":20,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,1,17]]},"published-print":{"date-parts":[[2023,2]]}},"alternative-id":["10.1136\/sextrans-2021-055382"],"URL":"https:\/\/doi.org\/10.1136\/sextrans-2021-055382","relation":{},"ISSN":["1368-4973","1472-3263"],"issn-type":[{"value":"1368-4973","type":"print"},{"value":"1472-3263","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4,5]]}}}