vulvovaginitis: Infections & Treatment Flashcards
chancroid tx
azithromycin 1 g orally single dose OR ceftriaxone 250mg IM single dose
alter: cipro 500 mg BID PO x 3 days OR erythromycin 500 mg PO TID x 7 days
genital herpes (HSV 2)
primary infection: acyclovir 400 mg PO TID 7-10 days
OR
famciclovir 250mg PO TID 7-10 days
OR valacyclovir 1 g PO BID for 7-10 days
Episodic: acyclovir 800 mg TID for 2 days
OR 400 mg PO TID for 5 days OR valacyclovir 1g PO QID x 5 days, 500mg PO BID x 5 days
suppression: acyclovir 400mg PO BID, famciclovir 250 mg PO BID, valacyclovir 1g P QID
patient > 9 reoccurance can use 500mg vala QID and increase 1 g QID for breakthrough
lymphogranuloma venerum, L1, L2 , L3 of C trachomatis
doxcycline 100 mg PO BID for 21 days
alter: erythromycin 500mg QID for 21 days
nongonococcal urethritis and cervitis (c. trachomatis)
Note: assume coinfection of N gonorrhea with mycoplasma or c trach.
primary: azithromycin 1g PO single dose
OR doxycycline 100mg PO BID x 7 days
alter: erythromycin base 500mg PO QID or ofloxacin 300 mg BID, or levofloxacin 500 mg QID x 7 days
gonococcal urethritis and cervititis (N. gonorrhea)
assume N gonorrhea w/c. trach
primary: ceftriaxone 250mg IM single if uncomplicated
AND azithromycin 1 g single dose or doxcycline 100mg BID x 7 days
Alter if beta lactam allergy: azithromycin 2g single dose
genital warts (HPV)
podofilox cream 0.5% solution or imiquimod 5% cream by patient
provider applies liquid nitrogen ir cryoprobe, TCA, resin,
bacterial vaginosis microscope
pH > 4.5, homogenoues thin white-grey discharge, positive whiff test on amine KOH, clue cells on saline (too much lactobacilli)
BV tx
metronidazole 500mg BID x 7 days, or gel 0.75% 1 application (5g) QID for 5 days OR
clindamycin cream 2% at HS for 7 nights
alter: metro 2 g single dose single, clindamycin 300mg BID x 7 days; clindaymycine ovules 100g vaginally PM x 3 days, tinidazole 2 g PO daily x 2 days or 1 g PO daily x 5 days
tx sympomatic women and pregnant even if symptomatic
candidiasis microscope
KOH mount: hyphae, pseudohyphae, ph
candidiasis
Fluconazole 150mg PO single; butoconazole 2% SR cream; tioconazole 6.5%, miconazole 1200mg single dose
if complicated can fo flucanozole 150 mg x 2 doses
PID
ceftriaxone 250 mg IM + doxycycline 100mg BID x 14 days w or w/o metro 500 mg BID x 14 days
Trichomoniasis microscope
saline - motile organisms, WBC
Trichomoniasis tx
metronidazole 500mg PO BID x 7 days
or 2 g PO x 1
If asymptomatic pregnant - consider delaying
trich symptoms
strawberry cerviz, green frothy discharge,
