STI treatment

Question 1

what is reported to man health

Answer 1

gonorrhea
chlamydia
syphilis
HepB/C
HIV

Question 2

red flags for gonorrhea

Answer 2

fever, chills, joint pain = disseminated

Question 3

gonorrhea treatmetn in >9

Answer 3

ceftriaxone 250 IM single dose

azithro 1g PO single dose

Question 4

gonorrhea alternative treatment in >9

Answer 4

azithro 2g PO single dose

test of cure recommended

Question 5

why is azitrho 1g preferred over doxycycline 100 x 7day as an alternative

Answer 5

issues regarding compliance

tetracycline resistance

Question 6

gonorrhea in <9

Answer 6

cefixime 8mg/kg PO BID(needs follow up culture) or ceftriaxone 50mg/kg IM x 2 doses + azithro 20mg/kg PO single dose

Question 7

always use a macrolide in a kid with gonorrhea?

Answer 7

no due to pyloric stenosis

testing should be done for chlamydia

Question 8

treatment of disseminated gonhorrea in adults

Answer 8

ceftriaxone 2g IV daily + azithro 1g PO single dose
arthritis x 7days
meningitis x 14
endocarditis x 28
opthalmia single dose

Question 9

ophthalmia neonatorum treatment

Answer 9

ceftriaxone 25mg/kg IM single dose
irrigate eyes with normal saline hourly
do testing for chlamydia
hospitalization and consultation with an expert

Question 10

treatment for neonates with disseminated infection

Answer 10

cefotaxime 50mg/kg IV q6h x14days
consult expert
test for chlamydia

Question 11

adult gonorrhea treatment for patients with cephalosporin resistance or allergy or anaphylactic reaction to penicillin

Answer 11

azithro 2g single dose + gentamicin 240mg IM/IV

Question 12

adult gonorrhea treatment with macrolide resistance and contraindications to cephalosporins

Answer 12

gentamicin 240mg IM/IV

Question 13

when should you repeat screening for ppl with gonorrheal infection

Answer 13

6 months post treatment

Question 14

when is a test of cure required in gonorrhea

Answer 14

anyone treated with an alternative regimen

use cultures taken 3-7 days after the completion of therapy

Question 15

treatment for chlamydia

Answer 15

azithromycin 1g PO in single dose

children 12-15mg/kg

Question 16

if vomiting occurs more than 1hr post admin do you need a repeat dose

Answer 16

no

Question 17

alternative therapy for chlamydial infections to azithro

Answer 17

100 BID for 7 days

Question 18

therapy for pregnant women

Answer 18

erythromycin 500 QID for 7 days
limited data on safety of azithro in pregnancy
weigh risk of theoretical effects vs non compliance

Question 19

pregnant women allergic to erythromycin or azithromycin treatment for chlamydia

Answer 19

amox 500 tid for 7 days

Question 20

treatment of primary, secondary, adn early latent syphillis

Answer 20

benzanthine penicillin G 2.4 million units IM as a single dose

Question 21

treatment of primary, secondayr, early latent syphilis with penicillin allergy

Answer 21

doxycycline 100 BID for 14 days

ceftriaxone 1g IV/IM for 10 days (exceptional circumstances

Question 22

treatment of late latent, latent of unknown duration, tertiary syphilis

Answer 22

benzathine penicillin G 2.4 million units IM for 3 dases

Question 23

treatment of late latent, latent of unknown duration, and tertiary syphilis in penicillin allergy

Answer 23

consider penicillin desensitization
doxy 100 BID for 28 days
ceftriaxone 1g IV/IM for 10 days (exceptional circumstances)

Question 24

treatment of epidemiological treatment of sexual contact in the preceding 90 days to primary, secondayr, and early latent syphilis

Answer 24

benzathine pen G 2.4 million units IM as a single dose

Question 25

treatment of pregnant women in primary, secondary, and early latent syphillis

Answer 25

benzathine pen G 2.4million units IM weekly for 1-2 doses

Question 26

alternative for pregnant women in beginning/later stages of syphilis

Answer 26

no satisfactory alternative
strongly consider penicillin desensitization
insufficient data exists to recommend ceftriaxone

Question 27

treatment for pregnant women in later stages of syphilis

Answer 27

benzathine pen G 2.4mill units IM weekly for 3 doses

Question 28

trichomonas treatment

Answer 28

metronidazole 2g PO in a single dose
or metro 500mg BID for 7 days
NOT INTRAVAGINAL

Question 29

do you treat the partner in trichomonas

Answer 29

yes increases effectiveness to 95%

Question 30

gardisal dosing for ages 9-14

Answer 30

2 doses 0 and 6 months

Question 31

gardisal dosing for males 15-26 and females 15-45

Answer 31

3 doses

0,2,6 months

Question 32

treatment for first genital herpes episode

Answer 32

acyclovir 400mg TID for 7-10 days

Question 33

suppresive therapy for genital herpes

Answer 33

acyclovir 400mg BID