Treatment for Male Partner of a Woman with Recurrent PID

Rationale for Treatment

The Centers for Disease Control and Prevention recommends that male partners of women with PID should be examined and treated if they had sexual contact with the patient during the 60 days preceding the patient's onset of symptoms 3, 4
Treatment is imperative because of the risk for reinfection of the female partner and the strong likelihood of urethral gonococcal or chlamydial infection in the male partner, even if asymptomatic 3, 4
Sex partners should be treated empirically with regimens effective against both chlamydia and gonorrhea, regardless of the etiology of PID or pathogens isolated from the infected woman 3, 4, 5

The male partner should be treated with ceftriaxone 500 mg IM in a single dose PLUS azithromycin 1 g orally in a single dose to cover both gonorrhea and chlamydia, regardless of whether pathogens were isolated from the female partner 1, 2
Azithromycin 1 g orally in a single dose also provides some coverage against Mycoplasma genitalium 2

Even though the female partner's vaginal swab was negative, empiric treatment is still recommended due to the possibility of false-negative test results 1
The pattern of recurrent infection in the female partner strongly suggests ongoing transmission from an untreated partner 1
After treatment, the couple should abstain from sexual intercourse until both partners have completed treatment and for 7 days after single-dose therapy or until completion of a multi-day regimen 1, 7

Testing for cure is not routinely recommended if recommended treatment is provided and symptoms resolve 7
Consider rescreening both partners 3 months after treatment due to high risk of reinfection 7
If symptoms persist or recur in either partner, they should return for evaluation 1
Both partners should be tested for other STIs including syphilis and HIV 1

Failing to treat partners empirically even when tests are negative 3, 4
Treating only for the organism identified in the female partner rather than providing coverage for both gonorrhea and chlamydia 3, 4
Not emphasizing the importance of abstinence during treatment and for 7 days after completion 1, 7