Sandbox ID Genitourinary

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Diseases Characterized by Genital, Anal, or Perianal Ulcers

Note: Ciprofloxacin is contraindicated for pregnant and lactating women. Patients should be tested for HIV infection at the time chancroid is diagnosed. If the initial test results were negative, a serologic test for syphilis and HIV infection should be performed 3 months after the diagnosis of chancroid. Sex partners of patients who have chancroid should be examined and treated if they had sexual contact with the patient during the 10 days preceding the patient's onset of symptoms.
  • Genital HSV infections[2]
  • First clinical episode of genital herpes
Note: Treatment can be extended if healing is incomplete after 10 days of therapy.
  • Recurrent genital herpes
  • Suppressive therapy
  • Episodic therapy
  • Severe disease
  • Preferred regimen: Acyclovir 5–10 mg/kg IV q8h for 2–7 days or until clinical improvement is observed, followed by PO antiviral therapy to complete at least 10 days of total therapy.
Note: Acyclovir dose adjustment is recommended for impaired renal function. Symptomatic sex partners should be evaluated and treated in the same manner as patients who have genital lesions. Asymptomatic sex partners of patients who have genital herpes should be questioned concerning histories of genital lesions and offered type-specific serologic testing for HSV infection.
  • HIV-infected patients
  • Suppressive therapy
  • Episodic therapy
  • Genital herpes in pregnancy
  • Acyclovir can be administered orally to pregnant women with first episode genital herpes or severe recurrent herpes.
  • Acyclovir should be administered IV to pregnant women with severe HSV infection.
  • Neonatal herpes

Gonococcal infection

  • Uncomplicated Gonococcal Infections of the Cervix, Urethra, and Rectum
  • Uncomplicated Gonococcal Infections of the Pharynx
  • Gonococcal Conjunctivitis
  • Disseminated Gonococcal Infection (DGI)
Note: All of the preceding regimens should be continued for 24-48 hours after improvement begins, at which time therapy can be switched to Cefixime 400 mg PO bid to complete at least 1 week of antimicrobial therapy.
  • Gonococcal Meningitis
  • Preferred regimen: Ceftriaxone 1-2 g IV every 12 hours for 10-14 days
  • Gonococcal Endocarditis
  • Preferred regimen: Ceftriaxone 1-2 g IV every 12 hours for at least 4 weeks
  • Gonococcal Infections Among Infants
  • Ophthalmia Neonatorum Caused by N. gonorrhoeae
  • Preferred regimen: Ceftriaxone 25-50 mg/kg IV or IM in a single dose, not to exceed 125 mg
  • DGI and Gonococcal Scalp Abscesses in Newborns
  • Preferred regimen:



Workowski, Kimberly A.; Berman, Stuart; Centers for Disease Control and Prevention (CDC) (2010-12-17). "Sexually transmitted diseases treatment guidelines, 2010". MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control. 59 (RR-12): 1–110. ISSN 1545-8601. PMID 21160459.




References

  1. Workowski, Kimberly A.; Berman, Stuart; Centers for Disease Control and Prevention (CDC) (2010-12-17). "Sexually transmitted diseases treatment guidelines, 2010". MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control. 59 (RR-12): 1–110. ISSN 1545-8601. PMID 21160459.
  2. Workowski, Kimberly A.; Berman, Stuart; Centers for Disease Control and Prevention (CDC) (2010-12-17). "Sexually transmitted diseases treatment guidelines, 2010". MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control. 59 (RR-12): 1–110. ISSN 1545-8601. PMID 21160459.
  3. Workowski, Kimberly A.; Berman, Stuart; Centers for Disease Control and Prevention (CDC) (2010-12-17). "Sexually transmitted diseases treatment guidelines, 2010". MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control. 59 (RR-12): 1–110. ISSN 1545-8601. PMID 21160459.
  4. Centers for Disease Control and Prevention (CDC) (2012-08-10). "Update to CDC's Sexually transmitted diseases treatment guidelines, 2010: oral cephalosporins no longer a recommended treatment for gonococcal infections". MMWR. Morbidity and mortality weekly report. 61 (31): 590–594. ISSN 1545-861X. PMID 22874837.