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Sexually Transmitted Diseases

Gonorrhea

Gonorrhea causes urethral, cervical, rectal, or pharyngeal infections.

Indications for Immediate Empiric Treatment

Mucopurulent cervicitis

Pelvic inflammatory disease

Contacts of persons with gonococcal infection or to presumptive gonococcal infection

Treatment of partners should be provided

Diagnostic Labs

Culture is recommended for public health purposes.

Test of cure is not necessary.

Serologic testing for syphilis and HIV should be considered.

Treatment of Uncomplicated Infections

Ceftriaxone (Rocephin) 250 mg IM; active against incubating syphilis OR

Cefixime (Suprax) 400 mg po; active against incubating syphilis OR

Ciprofloxacin (Cipro) 500 mg po; contraindicated <17 years of age; not active against syphilis OR

Ofloxacin (Floxin) 400 mg po; contraindicated <17 years of age; not active against syphilis.

Doxycycline 100 mg po bid x 7 days; for coexisting Chlamydia trachomatis infection; may abort incubating syphilis.

Alternative Regimens

Ceftizoxime 500 mg IM, cefotaxime 500 mg sexually transmitted diseases cefotetan 1 g IM, cefoxitin 2 g IM, cefuroxime axetil (Ceftin) 1 g po, cefpodoxime 200 mg po.

Enoxacin 400 mg po, lomefloxacin 400 mg po, or norfloxacin 800 mg po

Doxycycline 100 mg po bid x 7d. Sexually Transmitted Diseases, std, stds

Chlamydia Trachomatis

Chlamydia may cause urethritis, STD, STDs, stds cervicitis, conjunctivitis, or proctitis, clamidia.

Diagnostic Labs

Antigen testing is more rapid than culture for chlamydia.

Test of cure is not necessary if a recommended regimen was used.

Serologic testing for clamidia