STD Flashcards
Preferred & alternative medicine for urogenital & anorectal infection ?
Preferred:
Single “high dose” IM ceftriaxone
Alternative:
- Other cephalosporins
- Azithromycin + gentamycin /gemefloxacin
- Spectinomycin
What is the adverse effect of combining azithromycin w/ gemefloxacin ?
QT prolongation
What do you give a patient with gonorrhea & chlamydia?
Add to gonorrhea treatment doxycycline for 7 days
What is the 1st line & alternatives for pharyngeal gonococcal infection
1st lime :
Single dose IM ceftriaxone
Alternative:
Azithromycin + gentamicin
Spectinomycin —> not used —> poor penetration
What is the 1st line intreating gonococcal conjunctivitis ?
Single 1g IM ceftriaxone
Topical FQ
If cornea was involved in gonococcal conjunctivitis what do you give the pt?
IV 1g ceftriaxone every 12-24 hrs
What do you give a patient w/Disseminated gonococcal infection (DGI)?
Ceftriaxone 1 g IV every 24 hours
What is used for prophylaxis (preferred & alternative)in infants born to mothers with gonorrhea?
Erythromycin ophthalmic ointment in single application
Alternative: ceftriaxone IM /IV once
Early sphyilis preferred
Penicillin G benzathine 2.4 million IM once
Early sphyilis alternative
- Doxycycline or Tetracycline PO for 14 days
- Ceftriaxone 1-2 g daily IM or IV for 10-14 days
- Amoxicillin + probenecid , both given orally twice for 14 day
Late syphilis preferred
Penicillin G benzathine 2.4 million units IM once weekly for 3 weeks
Late sphyilis alternatives
- Doxycycline orally twice daily for four weeks
* Ceftriaxone 2 g daily IM or IV for 10 -14 days
Neurosyphilis preferred
Aqueous penicillin G 3 to 4 million units IV every 4 hours for 10
to 14 days
Neurosyphilis alternative
Ceftriaxone 2 g IV daily for 10 to 14 days
Congenital sphyilis treatment ?
1 Aqueous penicillin G, IV, B.i.D
- procaine penicillin G IM as a single daily dose for 10 days
- Benzathine penicillin G, IM, single dose
1st line for chlamydia
- Doxycycline ( preferred if co-infection with N.gonorrhea )
- Azithromycin
Doxycycline dose in chlamydia
100 mg twice daily for 7 days
Dose of azithromycin in chlamydia
1g single dose
Chlamydia alternatives
- Quinolones: ofloxacin orlevofloxacin for 7 days
2. Erythromycin & penicillin: less effective
Quinolones cautions
- Avoid in pregnancy or lactation
2. Avoid inadolescents younger <18 years of age (bone abnormalities)
Why is penicillin less effective in chlamydia
Bcz it can actually prolongate the presence of these pathogens ( they don’t die but they are in a state of stress as if it is dormant )
Pregnant women chlamydia treatment
Azithromycin 1 g single dose OR amoxicillin or erythromycin (7-14 days)
Newborn chlamydia mainfested as conjunctivitis & pneumonia treatment
Erythromycin 50 mg/kg orally in four divided doses for 14 days
• CAUTION: Both erythromycin & azithromycin could be associated with infantile hypertrophic pyloric stenosis (IHPS)
Erythromycin is the choice in children with which disease
Gonorrhea & chlamydia
And erythromycin is preffered than azi
