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Sexually Trasmitted Disease

Sexually Transmitted Disease              Sexually Transmitted Disease 2010 Guideline.pdf  |  STD_RX_2010.htm    Sexually Transmitted Diseases Treatment Guidelines 2006  MMWR  |    STD_RX2006   STD2006-2.htm http://www.cdc.gov/std/treatment/     California STD Guidelines 2004 Summary     CDC Guidelines for the Treatment of Sexually Transmitted Diseases 2002  -  Annals IM 20 August 2002 Volume 137

Chlamydia Infection Gonorrhea Infection   Syphilis Infection    HIV Infection Chancroid Genital Herpes Simplex Virus Infections Granuloma-Inguinale (Donovanosis) Lymphogranuloma Venereum HPV Vaccine

Diseases Characterized by Genital Ulcers Management of Patients Who Have Genital Ulcers Chancroid Genital Herpes Simplex Virus Infections Granuloma-Inguinale (Donovanosis) Lymphogranuloma Venereum Syphilis  HPV Vaccine

Diseases Characterized by Urethritis and Cervicitis Chlamydial Infections - Chlamydia    (Chlamydia trachomatis) Gonococcal Infections -  Gonorrhea  (Neisseria gonorrhoeae) Management of Male Patients Who Have Urethritis Etiology Confirmed Urethritis Management of Patients Who Have Nongonococcal Urethritis Management of Patients Who Have Mucopurulent Cervicitis (MPC) Urethritis can result from infectious and noninfectious conditions. Symptoms: discharge of mucopurulent or purulent material, dysuria, or urethral pruritis. Asymptomatic infections are common. N. gonorrhoeae and C. trachomatis are clinically important infectious causes of urethritis. If clinic-based diagnostic tools (Gram stain microscopy) are not available, patients should be treated for both gonorrhea and chlamydia.

Diseases Characterized by Vaginal Discharge -  Vaginitis   Management of Patients Who Have Vaginal Infections Bacterial Vaginosis Trichomoniasis Vulvovaginal Candidiasis Pelvic Inflammatory Disease Diagnostic Considerations Treatment Follow-Up Management of Sex Partners Prevention Special Considerations

Chancroid Azithromycin 1 gm PO x1  or Cipro 500 mg bid PO x3days  or Erythromycin 500 mg PO QID x1 week Ceftriaxone 250 mg IM x1 Genital Herpes For first episode: Acyclovir 400 mg tid x 7-10 days Famciclovir 250 mg tid x 7-10 days Valacyclovir 1 gm bid x 7-10 days For recurrent episodes: Acyclovir 400 mg tid x 5days or 800 mg bid x 5 days Famcyclovir 125 mg bid x 5 days Valacyclovir 500 mg bid x 5 days For suppressive Rx: Acyclovir 400 mg bid Famciclovir 250 mg bid Valacyclovir 250 mg bid or 500 mg daily Gonorrhea Cipro 500 mg PO x 1 dose Cefixine (Supra)  400 mg PO x 1 dose - may be discontinued by manufacture soon! Ceftriaxone (Rocephin) 125-250 mg IM x 1 (can be reconstituted with 1% lidocaine soln to reduce injection pain) Spectinomycin 2 gm IM x 1 Plus Azithromycin 1 gm PO x 1 or Doxycycline 100 mg bid x 7 days for Chlamydia Rx also.  Chlamydia   Azithromycin  (Zithromax) 1 gm  (4 tab of 250 mg tablet) PO x 1 , or Doxycycline 100 mg bid x 7 days * Evaluate, test, and treat all sexual partners within the last two months if possible. Treatment of Patients Who Have Nongonococcal Urethritis  Azithromycin 1 g orally in a single dose, OR Doxycycline 100 mg orally twice a day for 7 days. or Erythromycin base 500 mg orally qid for 7 days Erythromycin ethylsuccinate 800 mg orally qid for 7 days, Ofloxacin 300 mg twice a day for 7 days. Granuloma-Inguinale Trimethoprim-sulfamethoxazole one double-strength tablet orally twice a day for a minimum of 3 weeks, or Doxycycline 100 mg orally twice a day for a minimum of 3 weeks. Therapy should be continued until all lesions have healed completely. Alternative Regimens Ciprofloxacin 750 mg orally twice a day for a minimum of 3 weeks, OR Erythromycin base 500 mg orally four times a day for a minimum of 3 weeks. Syphilis  Benzathin Penicillin G 2.4 million units IM x 1 dose, or Doxycycline/Vibramycin 100 mg PO bid x 2 weeks, or Tetracycline 500 mg PO qid x 2 weeks For Early Latent Syphilis Penicllin G 2.4 million units IM x1 dose For Late Latent Syphilis Benzathin Penicllin G 2.4 million units IM x 3 consecutive weeks

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2010