Treatment Patterns for External Genital Warts in Australia, 1997

Objective: To describe the current treatment patterns for external genital warts employed by Australian doctors in 1997. Methods: Information regarding treatment modalities employed, maximum number of visits for each treatment type and referral patterns was obtained from a postal survey of general practitioners (GPs) and a telephone survey of sexual health clinic doctors across Australia. Results: Cryotherapy is the most common first line topical therapy employed by GPs for the treatment of external genital warts for both males (51%) and females (41%). The second most common treatment modality employed is podophyllin (29% and 33% respectively). Podophyllotoxin is not used extensively by GPs in either male (5%) or female (6%) patients. `Other therapies' are rarely used as first line therapy (3-5%). Cryotherapy and podophyllin involve at most, 3 to 4 visits to the clinic, although podophyllin requires on average 0.6 of a visit more than cryotherapy. Podophyllotoxin requires on average 2 to 3 visits, substantially less than podophyllin (p<0.05). In sexual health clinics, cryotherapy is the most common first and second line treatment employed for the management of external genital warts in both males (63% and 44% respectively) and females (53% and 51% respectively). Unlike GPs, sexual health clinic doctors use podophyllotoxin much more frequently both as first and second line treatments in both male and female patients. Referrals are made much less commonly representing only 3% of first line therapy and 6-11% of second line therapy selected. Discussion: Cryotherapy and topical podophyllin represent the vast bulk of first-line treatments in Australia for genital warts particularly in the General Practice sector. Podophyllotoxin certainly plays a bigger part in the treatment practices in the STD clinics particularly in the management of persistent warts. More aggressive therapies are uncommonly employed in either sectors.