Chapter 07. Sexually Transmitted Infections — Expedited Partner Therapy for Chlamydia, Gonorrhea, and Trichomoniasis
Regulation .01 Purpose and Scope.LinkCopy Citation
A.
The purpose of expedited partner therapy in Maryland is to:
(1)
Provide antibiotic therapy to any partner of a patient diagnosed with chlamydia, gonorrhea, or trichomoniasis without a personal physical assessment of the partner, and without having a previous provider-patient relationship with the partner;
(2)
Contain and stop the further spread of chlamydia, gonorrhea, and trichomoniasis; and
(3)
Reduce the likelihood of reinfection in the diagnosed patient.
B.
This chapter applies to the provision of expedited partner therapy, as described in §A of this regulation, in public and private health care settings.
Regulation .02 Definitions.LinkCopy Citation
A.
In this chapter, the following terms have the meanings indicated.
B.
Terms Defined.
(1)
“Antibiotic therapy” means the oral antibiotic treatment regimens:
(a)
Currently recommended by the Centers for Disease Control and Prevention for the treatment of chlamydia and gonorrhea through expedited partner therapy; and
(b)
For the treatment of trichomoniasis through expedited partner therapy:
(i)
In accordance with Regulation .05A of this chapter; and
(ii)
As authorized by Health-General Article, §18-214.1, Annotated Code of Maryland.
(2)
“Department” means the Maryland Department of Health.
(3)
“Expedited partner therapy (EPT)” means the prescribing or dispensing of antibiotic therapy to any partner of a patient diagnosed with chlamydia, gonorrhea, or trichomoniasis by certain health care providers without making a personal physical assessment of the partner, and without having a previous provider-patient relationship with the partner, in order to contain and stop the further spread of the infection and reduce the likelihood of reinfection in the diagnosed patient.
(4)
“Health officer” means the health officer in each of the 23 counties and the Commissioner of Health in Baltimore City, or the duly designated representative of the health officer, or both.
(5)
“Partner” means an individual with whom one has, or has had, oral, anal or vaginal sexual contact.
Regulation .03 Partners Eligible for EPT.LinkCopy Citation
Partners eligible for EPT are:
A.
Any partner within 60 calendar days of the patient’s diagnosis; or
B.
The most recent partner of a patient if the patient has not had sex in the 60 days before diagnosis.
Regulation .04 Health Care Providers Authorized to Prescribe and Dispense EPT.LinkCopy Citation
Notwithstanding any other provision of law, and only in accordance with their current scope of practice, EPT may be prescribed or dispensed by the following health care providers:
A.
A physician licensed under Health Occupations Article, Title 14, Annotated Code of Maryland;
B.
An authorized physician assistant licensed under Health Occupations Article, Title 15, Annotated Code of Maryland, acting in accordance with Health Occupations Article, §15-302.2, Annotated Code of Maryland;
C.
An advanced practice registered nurse with prescriptive authority licensed under Health Occupations Article, Title 8, Annotated Code of Maryland, acting in accordance with Health Occupations Article, §8–508, Annotated Code of Maryland; and
D.
A registered nurse employed by a local health department who complies with:
(1)
The formulary developed and approved under Health-General Article, §3-403(b), Annotated Code of Maryland; and
(2)
The requirements established under Health Occupations Article, §8-512, Annotated Code of Maryland.
Regulation .04-1 Pharmacists Authorized to Dispense EPT.LinkCopy Citation
Notwithstanding any other provision of law, a pharmacist licensed under Health Occupations Article, Title 12, Annotated Code of Maryland, may dispense antibiotic therapy for EPT prescribed in accordance with Regulation .04 of this chapter.
Regulation .05 Prescribing and Dispensing EPT Medications.LinkCopy Citation
A.
Antibiotic therapy prescribed or dispensed for EPT shall be in accordance with treatment recommendations from the Centers for Disease Control and Prevention.
B.
Prescribing.
(1)
A separate prescription shall be issued for each partner.
(2)
The designation “EPT” or “Expedited Partner Therapy” shall be included on the face of the prescription for each prescription issued.
(3)
If the partner’s name is known, the prescription shall be issued in the partner’s name.
(4)
If the partner’s name is unknown, the written designation “EPT” or “expedited partner therapy” shall be sufficient for the pharmacist to fill the prescription.
(5)
An EPT prescription may not be refilled.
C.
Dispensing. Each EPT medication label shall:
(1)
Include:
(a)
The designation “EPT” or “Expedited Partner Therapy”; and
(b)
The partner’s name, if known; and
(2)
Comply with Health Occupations Article, §12-505, Annotated Code of Maryland.
Regulation .06 Counseling and Educational Information Requirements.LinkCopy Citation
A.
A health care provider prescribing or dispensing EPT to a patient shall:
(1)
Counsel the patient to encourage each partner to seek a personal physical assessment; and
(2)
Provide the patient with educational information for each partner, in accordance with §C of this regulation.
B.
A pharmacist dispensing EPT shall provide educational information for each partner, in accordance with §C of this regulation.
C.
The educational information, that is available or comparable to that available on the Department’s website, shall include:
(1)
Advice for the partner to seek a medical evaluation;
(2)
Information about chlamydia, gonorrhea, and trichomoniasis;
(3)
Medication instructions;
(4)
Warnings about adverse drug or allergic reactions; and
(5)
Advice to abstain from sexual activity as required during treatment.
Regulation .07 Documenting EPT in a Medical Chart.LinkCopy Citation
A.
A health care provider prescribing or dispensing EPT shall document the provision of EPT in the patient’s chart.
B.
Documentation shall include the:
(1)
Number of EPT prescriptions or medications provided to the patient for each partner; and
(2)
Medication and dosage being provided to the patient for each partner.
Regulation .08 Reporting of Chlamydia and Gonorrhea by a Health Care Provider or Institution.LinkCopy Citation
A.
This chapter may not affect the obligation of a health care provider or institution to report to a health officer cases of chlamydia and gonorrhea and the treatment provided to those cases in accordance with COMAR 10.06.01.04.
B.
When reporting a case of chlamydia or gonorrhea for which EPT was prescribed or dispensed, a health care provider or institution shall report the number of partners for whom:
(1)
Prescriptions were provided; and
(2)
Medications were dispensed.
Chapter annotations
Authority: Health-General Article, §§2-104(b), 18-102, 18-201, 18-202, and 18-214.1, Annotated Code of Maryland
History: Effective date: March 28, 2016 (43:6 Md. R. 406)
History: Regulation .01A amended effective March 26, 2018 (45:6 Md. R. 318)
History: Regulation .02B amended effective March 26, 2018 (45:6 Md. R. 318)
History: Regulation .04-1 adopted effective March 26, 2018 (45:6 Md. R. 318)
History: Regulation .05A, B amended effective March 26, 2018 (45:6 Md. R. 318)
History: Regulation .06C amended effective March 26, 2018 (45:6 Md. R. 318)