Genitourinary med organism and pharma

Question 1

Bacterial vaginosis

Answer 1

Gardnerella vaginalis (most common)
Mycoplasma hominis
Prevotella species

Metronidazole 1st line, Clindamycin

Question 2

Candidiasis

Answer 2

Candida albicans

Clotrimazole 500mg PV once
Fluconazole 150mg PO once

Question 3

Chlamydia

Answer 3

Chlamydia trachomatis is a gram-negative bacteria

Doxycycline 100mg twice a day for 7 days

Question 4

Lymphogranuloma Venereum

Answer 4

Condition affecting the lymphoid tissue around the site of infection with chlamydia
Doxycycline 100mg twice daily for 21 days

Question 5

Gonorrhoea

Answer 5

Neisseria gonorrhoeae is a gram-negative diplococcus bacteria

A single dose of intramuscular ceftriaxone 1g if the sensitivities are NOT known
A single dose of oral ciprofloxacin 500mg if the sensitivities ARE known

Question 6

Mycoplasma genitalium

Answer 6

Mycoplasma genitalium (MG) is a bacteria that causes non-gonococcal urethritis

Doxycycline 100mg twice daily for 7 days then;
Azithromycin 1g stat then 500mg once a day for 2 days (unless it is known to be resistant to macrolides)

Moxifloxacin is used as an alternative or in complicated infections. Azithromycin alone is used in pregnancy and breastfeeding (remember doxycycline is contraindicated).

Question 7

PID

Answer 7

A single dose of intramuscular ceftriaxone 1g (to cover gonorrhoea)

Doxycycline 100mg twice daily for 14 days (to cover chlamydia and Mycoplasma genitalium)

Metronidazole 400mg twice daily for 14 days (to cover anaerobes such as Gardnerella vaginalis)

Question 8

Trichomonas vaginalis

Answer 8

Protozoan, and is a single-celled organism with flagella

Treatment is with oral metronidazole for 5-7 days or one off dose of 2g

Question 9

Herpes

Answer 9

Aciclovir

Question 10

Syphilis

Answer 10

Treponema pallidum. This bacteria is a spirochete, a type of spiral-shaped bacteria

A single deep intramuscular dose of benzathine benzylpenicillin