Treatment-sexually transmitted infections

(MMWR 2021;70:1; JAMA 2022;327:161)

• Syphilis 1°/2°/early latent: PCN G benzathine 2.4 mil U IM × 1 3°/late latent: PCN G 2.4 mil U IM × 3 Neuro: IV PCN G 4 mil U q4h 10–14 d (CID 2011; 53:S110)

• LGV: doxy 100 mg BID × 21 d + aspiration of buboes

• Donovanosis: azithro 1g qwk × 3 wks, until healed (MMWR 2015;64)

• Genital herpes: valacyclovir 1g bid × 7–10 d. Consider suppression if >6 outbreaks/yr.

• Chancroid: azithro 1g × 1 PO or cipro 500 mg bid × 3 d

• GC: CTX 500 mg IM × 1 (if wt >150 kg, 1 g). CT: doxy 100 mg PO bid × 7 d (preferred) or azithro 1 g PO × 1. Do not need to treat both if neg NAAT. Retest at 3 mos.

• M. gen.: doxy 100 mg PO bid × 7 d, then: moxifloxacin 400 mg PO qd × 7 d

• Trich: ♀ → MNZ 500 mg PO bid or tinidazole 2 g PO qd × 7 d. ♂ → MNZ 2 g PO × 1.

• Bacterial vaginosis: MNZ 500 mg PO bid × 7 d or vaginal Rx w/ MNZ gel daily × 5 d