Microsoft word - treatment of stis summary revised nov 2011.doc

TREATMENT OF SEXUALLY TRANSMITTED INFECTIONS
CONDITION Ist line treatment
2nd line treatment
Comments

SYPHILIS
Penicillin allergy
Penicillin allergy
Penicillin allergy
3 days or Benzylpenicillin 18 – 24MU daily IV (3 –4MU 4 hrly) 17 days Plus prednisolone as above Penicillin allergy
treatment of neonate at birth with penicillin Or Azithromycin 500mg daily 10 days WITH treatment of neonate at birth with penicillin Penicillin allergy
C:\Documents and Settings\lknowles\Local Settings\Temporary Internet Files\OLK1EB\TREATMENT OF STIs summary revised GONORRHOEA
Test of cure required
Asymptomatic –
completion of
treatment
Symptomatic –
culture 72hrs after
completion of
treatment.
plus
Azithromycin 1G oral
single dose is an
alternative treatment if
a sensitive strain of
GC.
Spectinomycin 2g IM single
spectinomycin are all safe - avoid ciprofloxacin or tetracycline plus
Doxycycline 100mg BD
BD 7days
and
Ciprofloxacin 250mg
daily 3 days
Administration of
Reconstitute two vials ceftriaxone (250mg each) in 2mls of 1% lidocaine. ceftriaxone 500mg*
Give by a single deep intramuscular injection into the buttock. C:\Documents and Settings\lknowles\Local Settings\Temporary Internet Files\OLK1EB\TREATMENT OF STIs summary revised
CHLAMYDIA
Pregnancy – 2nd & 3rd
trimester: Azithromycin
Ist trimester:
Erythromycin 500mg oral BD 14 days or
All pregnant women
need TOC 6 weeks
after treatment

(less effective at high bacterial loads) plus
Doxycycline 100mg oral BD
14days
and
Metronidazole 400mg oral BD
14 days

NON SPECIFIC
URETHRITIS
Uncomplicated NSU
oral single dose (this has a higher failure rate) Azithromycin 500mg oral single Erythromycin 500mg Refer to CPC if QDS 3 weeks plus
Moxifloxacin 400mg
oral OD 10 days
plus
Metronidazole
400mg BD 5 days
C:\Documents and Settings\lknowles\Local Settings\Temporary Internet Files\OLK1EB\TREATMENT OF STIs summary revised TRICHOMONAS
for 48hrs after treatment- avoid alcohol Treat male partners epidemiologically. TOC after 1 week Metronidazole 400mg TDS oral oral 5 days then GENITAL HERPES
2% lidoocaine gel topically and oral analgesia Refer all pregnant
women with known or
suspected HSV to
CPC.

BACTERIAL
Pregnancy 1st
VAGINOSIS
Trimester: Amoxil
2nd & 3rd trimester:
dose. Clindamycin cream damages latex condoms Plus clotrimazole
plus clotrimazole 1% cream
plus aqueous cream as soap
pessaries 100mg PV for 6 -12
days
Or
Fluconazole 150mg oral two
C:\Documents and Settings\lknowles\Local Settings\Temporary Internet Files\OLK1EB\TREATMENT OF STIs summary revised doses 72hrs apart
plus Clotrimazole 1% cream
plus aqueous cream as soap
substitute
Plus aqueous cream as soap
substitute
GENITAL WARTS
Imiquimod 5%
cream nocte x3/
• Soft / exophytic:
treatment (Warticon cream
• Keratinised/ single or few
As above
• Keratinised /extensive:
Clinic based treatment with
cryotherapy and 25%
podophyllin. Consider
debulking first with podophyllin,
Warticon or Imiquimod cream.
MOLLUSCUM
CONTAGIOSUM
URINARY TRACT
INFECTION
Refer men with a documented UTI to Urology on at least 12hrs, reapply to hands after washing, wash bed clothes at 50°C Antihistamine or crotamiton cream to control itch C:\Documents and Settings\lknowles\Local Settings\Temporary Internet Files\OLK1EB\TREATMENT OF STIs summary revised PUBIC LICE
Retreat with different Screen & treat all after 12hrs
Or
Permethrin 1% cream rinse
(Lyclear)
-apply to dry hair & wash out
after 10 mins

Repeat application after 3-7
days
Eyelash infestation: smear with
Derbac-M or Lyclear whilst
keeping eye closed for 10
mins, then wash off
PEPSE TREATMENT
contraception & Hep B immunisation. Final HIV test 3 mths after completion of PEPSE C:\Documents and Settings\lknowles\Local Settings\Temporary Internet Files\OLK1EB\TREATMENT OF STIs summary revised

Source: http://www.sexualhealthkingston.co.uk/upload_folder/sti%20treatment%20guidelines%20as%20at%20nov%202011.pdf