Infectious Diseases II: STI's Flashcards
Sexual partners should also be treated for most STI’s except….
Bacterial vaginosis
syphilis
caused by spirochete, treponema pallidum
painless lesion on genitals, mouth or anus
DOC for primary, secondary, early latent (< 1 yr) syphilis
Pen G Benzathine (Bicillin L-A)
2.4 mil units IM x 1
Alternative agents for primary, secondary, early latent (< 1 yr) syphilis
Doxycycline 100 mg BID
Tetracycline 500 mg QID
x 14 days
DOC for pregnant pts
Pen G benzathine
If PCN allergy –> desensitize
DOC for late latent (> 1 yr), tertiary syphillis
Pen G benzathine 2.4 mil units weekly x 3 weeks
Alternative agents for late latent (> 1 yr), tertiary syphillis
Doxycycline 100 mg BID
Tetracycline 500 mg QID
x 28 days
DOC for neurosyphilis
Pen G aqueous 3-4 mil units q4h
or continuous infusion 18-24 mil units/day
x10-14 days
Alternative tx for neurosyphilis
Pen G procaine 2.4 mil units IM daily + probencid 500 mg QID x 10-14 days
DOC for congenital syphilis
Pen G aqueous
Altn: Pen G procaine
Gonorrhea
Caused by neisseria gonorrhoeae (Gram -)
Urethral, cervical, rectal, pharyngeal
Drug treatment for gonorrhea
Ceftriaxone 250 mg IM x 1 \+ Azithromycin 1 g PO x1 OR Doxycycline 100 mg BID x 7 days
Chlamydia
caused by Chlamydia trachomatis (Gram -)
DOC for chlamydia
Azithromycin 1 g x1
OR
DOxycycline 100 mg BID x 7
Alternative treatment for chlamydia
Erythromycin
Levofloxacin
Ofloxacin
Amoxicillin 500 mg TID x 7 (used in pregnancy)
Bacterial vaginosis
caused by many different organisms
causes “fishy” smell to vaginal secretions
Secretions pH > 4.5
Bacterial vaginosis treatment
Metronidazole PO 500 mg BID x 7 days
Metronidazole gel x 5 days
Clindamycin 2% cream x 7 days
Trichomoniasis
caused by trichomonas vaginalis (protozoa)
yellow-green vaginal discharge
Trichomoniasis treatment
Metronidazole 2 g x1 (altn 500 mg BID x 7)
Tinidazole 2 g x 1
CDC recommends metronidazole during pregnancy, even during 1st trimester
