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Brown Medical School
STI 101: Treatment Recommendations

April 2005

DiseaseRecommendationAlternative Regimen
Primary and Secondary syphilis Early Latent syphilis (<1 year duration)Benzathine penicillin 2.4 million units IM in a single injection

  1. Doxycycline 100 mg po bid for 14 days OR

  2. Tetracycline 500 mg po qid for 14 days
Latent syphilis (>1 year duration or unknown)Benzathine penicillin 2.4 million units IM for three doses at 1-week intervals

  1. Doxycycline 100 mg po bid for 28 days

  2. Tetracycline 500 mg qid for 28 days
NeurosyphilisAqueous crystalline penicillin G 18-24 million units per day, administered as 3-4 million units IV every 4 hours or continuous infusion, for 10-14 daysProcaine penicillin 2.4 million units IM once daily plus Probenicid 500 mg orally four times a day, both for 10-14 days
Syphilis during pregnancyPenicillin regimen appropriate for stage of syphilisPenicillin allergic pregnant patients should be desensitized to penicillin
GonorrheaCeftriaxone 125 mg IM in a single dose

  1. Ciprofloxacin 500 mg orally in a single dose OR

  2. Ofloxacin 400 mg orally in a single dose OR

  3. Levofloxacin 250 mg orally in a single dose

    Plus, treat for Chlamydia infection if it has not been ruled out.

Chlamydia

  1. Azithromycin 1 g orally in a single dose OR

  2. Doxycycline 100 mg orally twice daily for 7 days

  1. Erythromycin base 500 mg orally four times daily for 7 days OR

  2. Erythromycin ethylsuccinate 800 mg orally four times daily for seven days OR

  3. Ofloxacin 300 mg orally twice daily for 7 days OR

  4. Levofloxacin 500 mg orally daily for 7 days
Chlamydia during pregnancy

  1. Erythromycin base 500 mg orally four times daily for 7 days OR

  2. Amoxicillin 500 mg orally three times daily for 7 days

  1. Erythromycin base 500 mg orally four times daily for 14 days OR

  2. Erythromycin ethylsuccinate 800 mg orally four times daily for 7 days OR

  3. Erythromycin ethylsuccinate 400 mg orally four times daily for 14 days OR

  4. Azithromycin 1 g orally in a single dose
HSV, first clinical episode

  1. Acyclovir 400 mg three times daily for 7-10 days OR

  2. Valacyclovir 1 g orally twice daily for 7-10 days OR

  3. Famciclovir 250 mg orally three times daily OR

  4. Acyclovir 200 mg orally five times daily
 
Genital herpes, recurrenceEpisodic therapy:

  1. Above regimens for 5 days

  2. Valacyclovir 500 mg for 3-5 days
Suppressive therapy:

  1. Acyclovir 400 mg orally twice daily, indefinitely OR

  2. Famciclovir 250 mg orally twice daily OR

  3. Valacyclovir 500 mg orally once daily OR

  4. Valacyclovir 1 g orally once daily
Hepatitis A* -  - 
Hepatitis B* -  - 
*Chronic hepatitis A and B treatment are beyond the scope of this text.

This article was provided by Brown Medical School, and is a part of the publication Infectious Diseases in Corrections Report.


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