Vaginitis and STI Treatment Flashcards
Chancroid Treatment
USE ONE:
- Azithromycin 1g orally for one dose
- Ceftriaxone 250mg IM for one dose
- Ciprofloxacin 500mg orally BID x 3 days
- Erythromycin base 500mg orally TID x 7 days
Syphilis Treatment (including early latent)
Benzathine penicillin G 2.4 million units IM x 1 dose
If pt is allergic, send to ED for observed desensitization. ALWAYS treat with penicillin!!
Late Latent or Latent Syphilis of Unknown Duration Treatment
Benzathine penicillin G 7.2 million units total, administered as 3 doses of 2.4 million units IM at 1 week intervals
Chlamydia Treatment
USE ONE:
- Azithromycin 1g orally in a single dose
- Doxycycline 100mg orally BID x 7 days
Gonorrhea Treatment (infection of cervix, urethra, rectum, or pharynx)
Ceftriaxone 250mg IM in a single dose
AND
Azithromycin 1g orally in a single dose
Gonorrhea Treatment (conjunctivitis)
Ceftriaxone 1g IM in a single dose
AND
Azithromycin 1g orally in a single dose
Bacterial Vaginosis Treatment
USE ONE:
- Metronidazole 500 mg orally BID x 7 days
- Metronidazole gel 0.75%, 5 g applicator intravaginally daily x 7 days
- Clindamycin cream 2%, 5 g applicator intravaginally qHS x 7 days
Cervicitis Treatment
USE ONE (and consider also tx for GC if at high risk):
- Azithromycin 1g orally in a single dose
- Doxycycline 100 mg orally BID x 7 days
Genital Herpes Simplex Treatment
First clinical episode
USE ONE:
- Acyclovir 400 mg orally TID x 7 - 10 days
- Acyclovir 200 mg orally 5x/day x 10 days
- Valacyclovir 1 g orally BID x 7 - 10 days
- Famciclovir 250 mg orally TID x 7 - 10 days
Genital Herpes Simplex Treatment
Episodic therapy for recurrent outbreak
USE ONE:
- Acyclovir 400 mg orally TID x 5 days
- Acyclovir 800 mg orally BID x 5 days
- Acyclovir 800 mg orally TID x 2 days
- Valacyclovir 500 mg orally BID x 3 days
- Valacyclovir 1 g orally x 5 days
- Famciclovir 125 mg orally BID x 5 days
- Famciclovir 1000 mg orally BID x 1 day
- Famciclovir 500 mg orally x 1 followed by 250 mg BID x 2 days
Genital Herpes Simplex Treatment
Suppressive therapy for recurrent outbreaks
USE ONE:
- Acyclovir 400 mg orally BID
- Valacyclovir 500 mg orally q day
- Valacyclovir 1 g orally q day
- Famcyclovir 250 mg orally BID
Genital Herpes Simplex Treatment
Episodic treatment for people with HIV infection
USE ONE:
- Acyclovir 400 mg orally TID x 5 - 10 days
- Valacyclovir 1 g orally BID x 5 - 10 days
- Famciclovir 500 mg orally x 5 - 10 days
Genital Herpes Simplex Treatment
Suppressive treatment for people with HIV infection
USE ONE:
- Acyclovir 400 - 800 mg orally BID-TID
- Valacyclovir 500 mg orally BID
- Famciclovir 500 mg orally BID
Genital Warts Treatment (external genital and perianal warts)
Patient applied
USE ONE:
- Imiquimod 3.75% cream to warts qHS x 16 weeks, wash off with soap and water after 6 - 10 hours
- Imiquimod 5% cream to warts 3x/week x 16 weeks, wash off with soap and water after 6 - 10 hours
- Podofilox 0.5% solution or gel to warts BID x 3 days, followed by 4 days off. Can repeat this cycle PRN. Contraindicated during pregnancy
- Sinecatechins 15% ointment to warts TID x up to 16 weeks. Don’t wash off. No sex with ointment on. Pregnancy safety unknown
Genital Warts Treatment
Provider administered
USE ONE:
- Cryotherapy
- Trichloroacetic acid or bichloroacetic acid 80 - 90% q week PRN
- Surgical removal
Lymphogranuloma Venereum Treatment
Doxycycline 100 mg orally BID x 21 days
Pediculosis Pubis Treatment
USE ONE:
- Permethrin 1% cream rinse, apply to affected area and rinse after 10 minutes
- Pyrethrins with piperonyl butoxide, apply to affected area and rinse after 10 minutes
Pelvic Inflammatory Disease Treatment
Intramuscular/Oral Regimen
USE ONE:
- Ceftriaxone 250 mg IM single dose PLUS Doxycycline 100 mg orally BID x 14 days WITH OR WITHOUT Metronidazole 500 mg BID x 14 days
- Cefoxitin 2 g IM single dose PLUS Probenecid 1 g orally concurrently single dose PLUS Doxycycline 100 mg BID x 14 days WITH OR WITHOUT Metronidazole 500 mg BID x 14 days
Scabies Treatment
USE ONE:
- Permethrin 5% cream, apply everywhere from neck down, wash off after 8 - 14 hours
- Invermectin 200mcg/kg orally, repeated in 2 weeks
Trichomoniasis Treatment
NOT persistent or recurrent
USE ONE:
- Metronidazole 2 g orally in a single dose
- Tinidazole 2 g orally single dose
Trichomoniasis Treatment
Persistant or recurrent infection
Metronidazole 500 mg orally BID x 7 days
*If that fails: treat with either Metronidazole or Tinidazole 2 g orally BID x 7 days
Vulvovaginal Candidiasis Treatment
USE ONE:
- Oral Agents:
a) Fluconazole 150 mg orally in a single dose - Over-the-Counter Intravaginal Agents:
a) Clotrimazole 1% cream 5 g intravaginally daily for 7–
14 days
b) Clotrimazole 2% cream 5 g intravaginally daily for 3 days
c) Miconazole 2% cream 5 g intravaginally daily for 7 days
d) Miconazole 4% cream 5 g intravaginally daily for 3 days
e) Miconazole 100 mg vaginal suppository, one suppository daily for 7 days
f) Miconazole 200 mg vaginal suppository, one suppository for 3 days
g) Miconazole 1,200 mg vaginal suppository, one suppository for 1 day
h) Tioconazole 6.5% ointment 5 g intravaginally in a single application - Prescription Intravaginal Agents:
a) Butoconazole 2% cream (single dose bioadhesive product), 5 g intravaginally in a single application
b) Terconazole 0.4% cream 5 g intravaginally daily for 7 days
c) Terconazole 0.8% cream 5 g intravaginally daily for 3 days
d) Terconazole 80 mg vaginal suppository, one suppository daily for 3 days
