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Second Chance - STIs

Treatment for Chlamydia include:
Azithromycin 1 gram PO in a single dose
Doxycycline 100 mg PO BID for 7 days
Treatment for Gonorrhea include:
Ceftriaxone 250 mg IM in a single dose PLUS Azithromycin 1 gram PO in a single dose
Azithromycin 1 gram PO in a single dose
Treatment for Gonorrhea include: (cephalosporin allergy)
Gemifloxacin 320 mg PO single dose + Azithromycin 2 g PO single dose
Switch to Doxycycline 100 mg PO BID for 7 days (still use Ceftriaxone)
Treatment for 1st ep of genital herpes:
Valacyclovir 1g PO BID x 7 days
€˘ Valacyclovir 500 mg PO BID for 3 days
Treatment for subsequent eps of herpes:
€˘ Valacyclovir 1 g PO daily for 5 days
Valacyclovir 1g PO BID x 7 days
Syphillis treatment for primary & secondary?
Benzathine penicillin G 2.4 million units IM in a single dose
ALWAYS GIVE IT INTRAMUSCULARLY
PCN allergy non-pregnant: Doxy 100mg PO BID x 14 days
Latent syphillis tx?
Benzathine penicillin G 2.4 million units IM in a single dose
Tertiary syphillis tx?
Benzathine penicillin G 2.4 million units IM weekly for 3 weeks (7.2 million units total)
PCN allergy? consult ID
Neurosyphilis tx?
Aqueous crystalline penicillin G 18-24 million units per day delivered as either 3-4 million units IV Q4H or continuous infusion for 10-14 days
Ceftriaxone 2 g IM or IV for 10 to 14 days for PCN allergy and not pregnant
Trichomoniasis tx?
Metronidazole 2g PO x 1 dose
 
Counseling for chlamydia and gonorrhea?
No sex until 7 days after tx initiated if sx resolve
Re-evaluate only when sx persist or pregnant
Test of cure for chlamydia only if pregnant after 3-4wks post-tx
When should re-test occur for chlamydia and gonorrhea?
3mo after tx or within following 12 months when patient seeks care
 
Characteristic of syphillis?
Painless genital chancre
Profuse and purulent discharge
Mucoid discharge
Characteristic of gonorrhea?
Painless genital chancre
Profuse and purulent discharge
Mucoid discharge
Characteristic of chlamydia?
Painless genital chancre
Profuse and purulent discharge
Mucoid discharge
Characteristic of Trichomoniasis?
Painless genital chancre
Profuse and purulent discharge
Mucoid discharge
Malodorous yellow-green vaginal discharge
Counseling for Trichomoniasis?
Re-screen females in 3 months
No sex until tx complete and asymptomatic
Avoid EtOH during tx and 7rs after completion
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