Infekcje przenoszone drogą płciową

Infekcje przenoszone drogą płciową
Leczenie

Infekcje przenoszone drogą płciową (STI) stanowią istotne wyzwanie zdrowia publicznego, wymagające szybkiej diagnostyki i adekwatnego leczenia, aby zapobiec powikłaniom i transmisji. Bakteriologiczne STI, takie jak chlamydia, rzeżączka, kiła i rzęsistkowica, są zwykle uleczalne przy zastosowaniu schematów antybiotykoterapii, np. doksycyklina 100 mg p.o. 2x/d przez 7 dni w chlamydii, ceftriakson 500 mg i.m. (1 g dla masy ciała ≥150 kg) w rzeżączce, penicylina G benzatynowa 2,4 mln j. i.m. w kile oraz metronidazol 500 mg p.o. 2x/d przez 7 dni w rzęsistkowicy. Leczenie partnerów seksualnych (np. ekspedycyjna terapia partnerska) jest kluczowe dla zapobiegania reinfekcji. W przypadku Mycoplasma genitalium zaleca się terapię dwuetapową: doksycyklina, a następnie azytromycyna lub moksyfloksacyna w zależności od oporności. W leczeniu wirusowych STI, takich jak opryszczka narządów płciowych, stosuje się leki przeciwwirusowe (acyklowir, famcyklowir, walacyklowir) w celu łagodzenia objawów, natomiast HIV wymaga wysoce aktywnej terapii antyretrowirusowej (HAART) dla kontroli wiremii i zapobiegania transmisji (U=U). W przypadku wirusowego zapalenia wątroby typu B dostępne są leki przeciwwirusowe (np. adefowir, entekawir, interferon alfa).

Leczenie infekcji przenoszonych drogą płciową

Leczenie infekcji bakteryjnych
Leczenie infekcji wirusowych
Szczególne aspekty leczenia STI
Zalecenia dotyczące testowania i monitorowania
Zapobieganie infekcjom przenoszonym drogą płciową

Kompleksowe podejście do leczenia STI

Zalecenia praktyczne dla pacjentów
Nowe strategie w leczeniu STI
Kolejne rozdziały

Leczenie infekcji przenoszonych drogą płciową

Infekcje przenoszone drogą płciową (STI) stanowią poważny problem zdrowia publicznego zarówno w krajach rozwiniętych, jak i rozwijających się. Leczenie tych infekcji zależy od konkretnego czynnika patogennego, a wczesna diagnoza i terapia są kluczowe dla zapobiegania powikłaniom i dalszemu rozprzestrzenianiu się infekcji w społeczeństwie.¹²

Głównym celem leczenia infekcji przenoszonych drogą płciową jest: wyleczenie wielu (nie wszystkich) STI, złagodzenie objawów, zmniejszenie prawdopodobieństwa rozprzestrzeniania się infekcji oraz pomoc pacjentowi w odzyskaniu i utrzymaniu zdrowia.¹ Prawidłowe i skuteczne leczenie infekcji przenoszonych drogą płciową, najlepiej podane i przyjęte tego samego dnia przy pierwszym kontakcie pacjenta z personelem medycznym, jest ważnym środkiem zdrowia publicznego w kontroli STI, ponieważ ma na celu przerwanie łańcucha transmisji infekcji bez opóźnień.¹

Leczenie infekcji bakteryjnych

Infekcje przenoszone drogą płciową wywołane przez bakterie są zazwyczaj łatwiejsze do leczenia niż infekcje wirusowe.¹ Trzy bakteryjne infekcje (chlamydia, rzeżączka i kiła) oraz jedna pasożytnicza (rzęsistkowica) są zwykle uleczalne przy zastosowaniu istniejących jednodawkowych schematów antybiotykoterapii.¹

Antybiotyki, często w pojedynczej dawce, mogą wyleczyć wiele STI wywołanych przez bakterie lub pasożyty, takich jak rzeżączka, kiła, chlamydia i rzęsistkowica.¹ W przypadku kobiet w ciąży szybkie rozpoczęcie leczenia może zapobiec lub zmniejszyć ryzyko zakażenia płodu lub noworodka.¹²

Chlamydia

Chlamydia to jedna z najczęstszych infekcji przenoszonych drogą płciową, która może być leczona antybiotykami.¹ Zgodnie z zaktualizowanymi wytycznymi CDC z 2021 roku, zalecanym leczeniem chlamydii u osób niebędących w ciąży jest doksycyklina 100 mg doustnie dwa razy dziennie przez 7 dni.¹² Azytromycyna jest uznawana za alternatywny lek, ponieważ może być mniej skuteczna w leczeniu chlamydii odbytniczej.¹

Doksycyklina jest nadal lekiem pierwszego wyboru w leczeniu zakażeń chlamydią ze względu na konsekwentną skuteczność w leczeniu infekcji cewki moczowej, odbytnicy i gardła.¹ Jest to szczególnie ważne, ponieważ nieleczona chlamydia może prowadzić do poważnych powikłań zdrowotnych, w tym niepłodności u kobiet.¹

Rzeżączka

Rzeżączka jest leczona antybiotykami, chociaż rosnąca oporność na antybiotyki ogranicza opcje leczenia doustnego.¹ Zgodnie z wytycznymi CDC z 2021 roku, przy niepowikłanym zakażeniu rzeżączką ceftriakson pozostaje podstawowym leczeniem, ale obecnie zaleca się pojedynczą dawkę 500 mg domięśniowo lub dawkę 1 g domięśniowo dla pacjentów ważących 150 kg lub więcej.¹²

Wcześniejsze wytyczne CDC zalecały rutynową terapię dwulekową w celu powstrzymania pojawiającej się oporności na leki. Jednak nowe wytyczne odzwierciedlają obawy dotyczące zarządzania antybiotykoopornością i potencjalnych szkód wynikających z nadużywania antybiotyków. W związku z tym, współleczenie rzeżączki azytromycyną lub doksycykliną nie jest już zalecane.¹

Test kontrolny po leczeniu nie jest konieczny dla osób z rzeżączką cewki moczowej lub odbytnicy, ale jest zalecany 14 dni po leczeniu pacjentów z infekcją gardła.¹

Kiła

Kiła jest poważną infekcją bakteryjną, która może być łatwo leczona antybiotykami, jeśli zostanie wcześnie wykryta.¹² Zalecanym leczeniem pozostaje penicylina G benzatynowa podawana domięśniowo, w dawce 2,4 miliona jednostek, w pojedynczej dawce przy zakażeniu trwającym mniej niż rok, natomiast zakażenie utrzymujące się ponad rok lub o nieznanym czasie trwania powinno być leczone trzema kolejnymi tygodniowymi dawkami po 2,4 miliona jednostek każda.¹

Lekarze powinni upewnić się, że podawana jest właściwa forma penicyliny G benzatynowej (Bicillin L-A) do wstrzyknięć domięśniowych.¹ Bardzo ważne jest dokładne badanie pod kątem objawów usznych, ocznych i neurologicznych u każdej osoby z kiłą, ponieważ powikłania te mogą wystąpić na każdym etapie choroby i wymagają 10-14-dniowego leczenia dożylną wodną krystaliczną penicyliną G.¹

Rzęsistkowica

Rzęsistkowica to infekcja wywoływana przez pasożyta, która jest łatwo leczona lekami przeciwpasożytniczymi i antybiotykami.¹ Zgodnie z wytycznymi z 2021 roku, rzęsistkowica pochwy powinna być leczona 7-dniowym schematem metronidazolu.¹ Inne leki stosowane w leczeniu rzęsistkowicy to tynidazol i seknidazol.¹

Obecni partnerzy seksualni osób zakażonych rzęsistkowicą powinni zostać skierowani na badania i leczenie. Ważne jest, aby doradzić pacjentom powstrzymanie się od aktywności seksualnej do czasu, gdy zarówno oni, jak i ich partnerzy seksualni zakończą terapię i uzyskają ustąpienie wszelkich objawów.¹

Mycoplasma genitalium

Pacjenci z rozpoznaniem Mycoplasma genitalium powinni być idealnie leczeni w podejściu dwuetapowym, wykorzystując terapię ukierunkowaną na oporność. Początkowe leczenie doksycykliną zmniejsza obciążenie organizmu i ułatwia eliminację patogenu, a następnie stosuje się azytromycynę, jeśli izolat Mycoplasma genitalium jest wrażliwy na makrolidy, lub moksyfloksacynę, jeśli izolat jest oporny na makrolidy lub jeśli badanie oporności jest niedostępne.¹

Leczenie infekcji wirusowych

Infekcje STI wywołane przez wirusy nie mogą być wyleczone, ale można leczyć objawy i zarządzać przebiegiem choroby za pomocą leków przeciwwirusowych.¹² Leki przeciwwirusowe mogą modulować przebieg choroby, chociaż nie mogą jej wyleczyć.¹

Opryszczka narządów płciowych

Opryszczka narządów płciowych jest wirusową infekcją, która powoduje bolesne owrzodzenia w okolicy narządów płciowych. Po zakażeniu wirus pozostaje w organizmie przez całe życie.¹ Leki przeciwwirusowe, takie jak acyklowir (Sitavig, Zovirax), famcyklowir (Famvir) i walacyklowir (Valtrex), mogą skrócić długość i nasilenie zarówno początkowych, jak i kolejnych wybuchów opryszczki.¹

Chociaż ogólnoustrojowe środki przeciwwirusowe są korzystne dla kontrolowania objawów i oznak opryszczki narządów płciowych, a także zapobiegania nawrotom i przenoszeniu na partnerów seksualnych, pacjentów należy poinformować, że opryszczka narządów płciowych jest zakażeniem przewlekłym, na które nie ma lekarstwa.¹

HIV/AIDS

Przy HIV osoby zakażone potrzebują specjalnych leków antyretrowirusowych, które kontrolują ilość wirusa w organizmie. Te leki, nazywane wysoce aktywną terapią antyretrowirusową (HAART), mogą pomóc ludziom żyć dłużej i zdrowiej oraz zapobiegać dalszemu przenoszeniu HIV na innych.¹

Im wcześniej rozpocznie się leczenie HIV, tym jest ono bardziej skuteczne. Jeśli pacjent przyjmuje leki zgodnie z zaleceniami, możliwe jest obniżenie poziomu wirusa we krwi do poziomu niewykrywalnego. W tym momencie pacjent nie będzie już przenosił wirusa na partnerów seksualnych.¹ Jest to często określane frazą „niewykrywalny = nietransmisyjny” lub U=U.¹

Wirusowe zapalenie wątroby

Celem leczenia wirusowego zapalenia wątroby typu B jest powstrzymanie uszkodzenia wątroby poprzez zapobieganie rozprzestrzenianiu się wirusa. Istnieje obecnie pięć leków zatwierdzonych do stosowania w zakażeniu wirusem zapalenia wątroby typu B: adefowir, entekawir, interferon alfa, lamiwudyna i pegylowany interferon.¹ W przypadku zapalenia wątroby typu B leki przeciwwirusowe mogą pomóc w zwalczaniu wirusa i spowolnieniu uszkodzenia wątroby.¹

Szczególne aspekty leczenia STI

Leczenie partnerów

Leczenie partnerów seksualnych jest kluczowym elementem skutecznego zarządzania infekcjami przenoszonymi drogą płciową. Partnerzy seksualni osób zakażonych muszą być leczeni jednocześnie, aby uniknąć ponownych infekcji.¹ Ekspedycyjna terapia partnerska (EPT) to praktyka kliniczna polegająca na dostarczaniu leków lub recept na leczenie STI bez konieczności badania partnerów osób zakażonych.¹²

EPT jest zalecana dla wszystkich partnerów seksualnych pacjentów z rzeżączką i/lub chlamydią, jeśli istnieje małe prawdopodobieństwo, że partner zgłosi się na badanie lekarskie.¹ Ekspedycyjna terapia partnerska pomaga zapobiegać reinfekcji i chroni zarówno pacjenta, jak i jego partnera.¹

Jeśli u pacjenta zdiagnozowano STI, ważne jest, aby poinformować wszystkich swoich partnerów seksualnych z ostatnich miesięcy. Pomaga to ograniczyć rozprzestrzenianie się infekcji przenoszonych drogą płciową. Jest to szczególnie ważne w przypadku kiły i HIV.¹

Leczenie podczas ciąży

Leczenie STI u kobiet w ciąży jest szczególnie ważne, ponieważ niektóre infekcje mogą być przekazywane podczas ciąży lub porodu.¹ Wczesne leczenie kiły u kobiet w ciąży może zapobiec przedwczesnemu porodowi, urodzeniu martwego dziecka, śmierci niemowlęcia i innym poważnym powikłaniom u noworodków.¹

W przypadku chlamydii u kobiet w ciąży zaleca się azytromycynę, 1 g doustnie w pojedynczej dawce.¹

Oporność na antybiotyki

Oporność na antybiotyki stanowi rosnący problem w leczeniu STI, szczególnie w przypadku rzeżączki i Mycoplasma genitalium.¹ Oporność na leki przeciwdrobnoustrojowe w przypadku STI, zwłaszcza rzeżączki, wzrosła gwałtownie w ostatnich latach i zmniejszyła opcje leczenia.¹

Z tego powodu ważne jest, aby zawsze kończyć przepisany kurs antybiotyków, nawet jeśli objawy ustąpią wcześniej.¹² Niezależnie od rodzaju infekcji i niezależnie od tego, jak szybko objawy ustąpią po rozpoczęciu leczenia, zakażona osoba i jej partner(zy) muszą przyjąć wszystkie leki przepisane przez lekarza, aby zapewnić pełne wyleczenie STI.¹

Zalecenia dotyczące testowania i monitorowania

Po zakończeniu leczenia STI ważne jest, aby przeprowadzić badania kontrolne w celu upewnienia się, że leczenie było skuteczne i nie doszło do ponownego zakażenia.¹ Pacjenci z chlamydią, rzeżączką lub rzęsistkowicą powinni być badani na obecność HIV i kiły oraz poddawani ponownym testom po trzech miesiącach.¹

Zaleca się wykonanie testu kontrolnego (NAAT dla każdego miejsca infekcji) dwa tygodnie po zakończeniu leczenia rzeżączki. Ponowne badanie w celu wykrycia ponownej infekcji zaleca się po 3 miesiącach.¹

W przypadku chlamydii, test kontrolny jest zalecany w przypadku chlamydii odbytniczej leczonej azytromycyną.¹

Zapobieganie infekcjom przenoszonym drogą płciową

Skuteczne interwencje zapobiegające STI obejmują badania przesiewowe, śledzenie kontaktów partnerów seksualnych i promowanie skutecznej antykoncepcji barierowej.¹ Użycie prezerwatyw jest nadal najlepszą barierową ochroną przed STI.¹

Najlepszym sposobem zapobiegania STI jest unikanie aktywności seksualnej (abstynencja).¹ W przypadku osób aktywnych seksualnie zaleca się regularnie badania na obecność STI, zwłaszcza jeśli mają nowych lub wielu partnerów seksualnych.¹

CDC zaleca coroczne badania przesiewowe dla aktywnych seksualnie kobiet w wieku poniżej 25 lat oraz dla starszych kobiet z podwyższonym ryzykiem infekcji (nowi lub wielu partnerów seksualnych, lub partner seksualny z STI).¹

Profilaktyka przed i po ekspozycji

Doksycyklina PEP (profilaktyka poekspozycyjna) jest metodą zapobiegania zakażeniu STI. Polega na przyjęciu dawki antybiotyku doksycykliny najlepiej w ciągu 24 godzin, ale nie później niż 72 godziny po stosunku oralnym, analnym lub pochwowym bez prezerwatywy.¹

Doksycyklina PEP udowodniła, że zmniejsza szanse na zarażenie się bakteryjnymi STI (kiłą, chlamydią i rzeżączką) o około dwie trzecie.¹ W czterech badaniach klinicznych doksycyklina, antybiotyk znany od dziesięcioleci, wykazała obiecujące wyniki w ochronie mężczyzn uprawiających seks z mężczyznami i kobiet transpłciowych przed zakażeniem chlamydią, rzeżączką i kiłą po stosunku bez prezerwatywy.¹

Ogólny wniosek z tych badań jest taki, że doksycyklina 200 mg (dwie kapsułki po 100 mg) przyjmowana w ciągu 72 godzin od stosunku bez prezerwatywy zmniejsza ryzyko nabycia rzeżączki, chlamydii lub kiły o 47 do 66 procent.¹

W przypadku HIV dostępna jest profilaktyka przedekspozycyjna (PrEP). Jeśli pacjent przyjmuje jedną tabletkę raz dziennie, może z prawie 100% skutecznością zapobiec HIV.¹ Według CDC, jeśli pacjent stosuje Truvada codziennie, może zmniejszyć ryzyko zarażenia się HIV poprzez seks o około 99%. Może również zmniejszyć ryzyko zarażenia się HIV poprzez stosowanie narkotyków w iniekcjach o ponad 74%.¹

Badania sugerują, że Descovy jest również skuteczny w zmniejszaniu ryzyka zarażenia się HIV poprzez seks. Stosowanie dodatkowych środków zapobiegawczych, takich jak prezerwatywy, może jeszcze bardziej zmniejszyć ryzyko i zapobiec innym STI.¹

Kompleksowe podejście do leczenia STI

Celem kompleksowego zarządzania przypadkami STI jest zapewnienie leczenia, uzyskanie wyleczenia, zmniejszenie zakaźności, zmniejszenie ryzyka rozwoju powikłań STI oraz ograniczenie lub zapobieganie przyszłym zachowaniom ryzykownym.¹

Skuteczne zarządzanie przypadkami składa się nie tylko z terapii przeciwdrobnoustrojowej w celu uzyskania wyleczenia i zmniejszenia zakaźności, ale także kompleksowej oceny i opieki nad zdrowiem seksualnym i reprodukcyjnym pacjenta oraz jego partnerów seksualnych.¹

Kraje powinny ustanowić i stosować znormalizowane krajowe protokoły leczenia STI. Standaryzacja zapewnia, że wszyscy pacjenci otrzymują odpowiednie i adekwatne leczenie na wszystkich poziomach opieki zdrowotnej.¹

Infekcja	Czynnik etiologiczny	Zalecane leczenie	Alternatywne opcje	Możliwość wyleczenia
Chlamydia	Bakteria	Doksycyklina 100 mg doustnie 2x dziennie przez 7 dni	Azytromycyna 1 g doustnie w pojedynczej dawce	Tak
Rzeżączka	Bakteria	Ceftriakson 500 mg domięśniowo (1 g dla ≥150 kg)	Konsultacja z ekspertem przy alergii na ceftriakson	Tak
Kiła	Bakteria	Penicylina G benzatynowa 2,4 mln j. domięśniowo (1 dawka dla <1 roku, 3 dawki dla ≥1 roku)	Doksycyklina przy alergii na penicylinę	Tak
Rzęsistkowica	Pasożyt	Metronidazol 500 mg doustnie 2x dziennie przez 7 dni	Tynidazol, seknidazol	Tak
Mycoplasma genitalium	Bakteria	Doksycyklina, następnie azytromycyna lub moksyfloksacyna (zależnie od oporności)	Moksyfloksacyna przy oporności na makrolidy	Tak
Opryszczka narządów płciowych	Wirus	Acyklowir, famcyklowir, walacyklowir	Leczenie objawowe	Nie (leczenie objawowe)
HIV/AIDS	Wirus	Wysoce aktywna terapia antyretrowirusowa (HAART)	Różne schematy leków antyretrowirusowych	Nie (leczenie przewlekłe)
Wirusowe zapalenie wątroby B	Wirus	Adefowir, entekawir, interferon alfa, lamiwudyna, pegylowany interferon	Zależne od stopnia zaawansowania choroby	Nie (leczenie przewlekłe)
HPV (brodawki narządów płciowych)	Wirus	Leczenie miejscowe (krioterapia, podofilotoksyna, kwas trichlorooctowy)	Zabiegi chirurgiczne, laser	Nie (leczenie objawowe)

Zalecenia praktyczne dla pacjentów

Po diagnozie STI ważne jest, aby pacjent przestrzegał kilku zasad:¹²

Ukończyć pełny kurs przepisanego leczenia, nawet jeśli objawy ustąpią wcześniej¹
Nie podejmować kontaktów seksualnych przez 7 dni po zakończeniu leczenia¹
Nie podejmować kontaktów seksualnych z partnerami z ostatnich 2-6 miesięcy (zależnie od infekcji), dopóki partnerzy nie zostaną przebadani i ewentualnie leczeni¹
Poinformować wszystkich partnerów seksualnych o diagnozie STI¹
Zgłosić się na badania kontrolne zgodnie z zaleceniami lekarza¹
Przeprowadzić pełne badania przesiewowe w kierunku innych STI¹

Postępowanie zgodnie z tymi zaleceniami pomoże zapewnić skuteczne leczenie infekcji, zapobiec ponownemu zakażeniu i ograniczyć rozprzestrzenianie się STI.¹

Nowe strategie w leczeniu STI

W ostatnich latach opracowano nowe strategie mające na celu poprawę diagnostyki i leczenia STI. Należą do nich:¹²

Wykorzystanie szybkich testów diagnostycznych, które pozwalają na diagnozę i leczenie podczas jednej wizyty¹
Wprowadzenie ekspedycyjnej terapii partnerskiej (EPT) w celu leczenia partnerów seksualnych bez konieczności badania¹
Profilaktyka przedekspozycyjna (PrEP) dla HIV i doksycyklina jako profilaktyka poekspozycyjna (PEP) dla bakteryjnych STI¹²
Podejście syndromowe do zarządzania STI w miejscach, gdzie dostęp do diagnostyki laboratoryjnej jest ograniczony¹

Szybka diagnoza mikrobiologiczna STI i natychmiastowe leczenie są najlepszym sposobem na przerwanie łańcucha transmisji.¹ Wdrożenie szybkich systemów diagnostyki mikrobiologicznej umożliwia wczesne leczenie w celu przerwania łańcucha transmisji i zapobiegania poważnym powikłaniom klinicznym.¹

Lekarze rodzinni mogą przyczynić się do zmniejszenia wskaźników STI poprzez szczegółowy wywiad dotyczący historii seksualnej, zwłaszcza u nastolatków i młodych dorosłych, zlecanie badań przesiewowych i leczenia w oparciu o zaktualizowane wytyczne CDC dotyczące STI oraz współpracę z departamentami zdrowia publicznego w zakresie zgłaszania chorób i usług partnerskich.¹

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#1 Prevention and treatment of sexually transmitted infections in high-risk individuals, including patients with HIV infection | Enfermedades Infecciosas y MicrobiologÃa ClÃnica (English Edition)
https://www.elsevier.es/en-revista-enfermedades-infecciosas-microbiologia-clinica-english-428-articulo-prevention-treatment-sexually-transmitted-infections-S2529993X19300012
Prevention and treatment of sexually transmitted infections in high-risk individuals, including patients with HIV infection […] Sexually transmitted infections are a global public health problem both due to their high prevalence and due to their morbidity. A rapid and precise diagnosis is key to establishing appropriate targeted treatment and also to decreasing dissemination of these diseases among the high-risk population. […] The treatment of STIs in people at high risk is especially important for a number of reasons. It reduces morbidity and mortality rates in both the short-term (e.g. chlamydial cervicitis and pelvic inflammatory disease) and the long-term (as may occur in HIV and late latent syphilis). Moreover, the treatment of both symptomatic and asymptomatic individuals helps shorten the period of transmissibility, preventing new infections.
#1 Sexually Transmitted Infections (STIs): Sexually Transmitted Diseases (STDs)
https://my.clevelandclinic.org/health/diseases/9138-sexually-transmitted-diseases–infections-stds–stis
A sexually transmitted infection (sexually transmitted disease) is a serious condition that can develop after you have sex. The good news is that most STI treatments can cure the infection, but not all types. […] STIs are serious illnesses that need treatment. Some, like the human immunodeficiency virus (HIV), have no cure and can be life-threatening without treatment. […] If you have an STI, it’s important to visit a healthcare provider to receive treatment. Some STIs are curable. […] The goal of sexually transmitted infection (sexually transmitted disease) treatment is to: Cure many (not all) STIs. Lessen your symptoms. Reduce your likelihood of spreading the infection. Help you get healthy and stay healthy. […] Treatment for STIs could include taking medications like: Antibiotics. Antivirals.
#1 Treatment & Care
https://www.who.int/teams/global-hiv-hepatitis-and-stis-programmes/stis/treatment-care
Correct and effective treatment of sexually transmitted infections (STIs) ideally given and taken on the same day, at the first contact between patients and health-care providers is an important public health measure in the control of STIs, since it endeavours to break the chain of transmission of the infection without delay. […] Countries should establish and use national standardized treatment protocols for STIs. Standardization ensures that all patients receive appropriate and adequate treatment at all levels of the health-care service. […] The purpose of comprehensive STI case management is to provide treatment, obtain cure, reduce infectiveness, reduce the risk of developing complications from STIs, and reduce or prevent future risk-taking behaviour. […] Thus, effective case management consists not only of antimicrobial therapy to obtain cure and reduce infectiousness, but also the comprehensive assessment and care of a patients sexual and reproductive health and that of their sex partners.
#1 Sexually transmitted diseases (STDs) – Diagnosis and treatment – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/sexually-transmitted-diseases-stds/diagnosis-treatment/drc-20351246
STDs may be treated in different ways based on the causes. Sexually transmitted infections caused by bacteria are generally easier to treat. STI infections caused by viruses can be managed and treated but not always cured. […] Treatment for sexually transmitted infections usually consists of one of the following, depending on the infection: […] Antibiotics, often in a single dose, can cure many STIs caused by bacteria or parasites, such as gonorrhea, syphilis, chlamydia and trichomoniasis. […] If you are pregnant and have an STD, getting treatment right away can prevent or lower the risk of your baby becoming infected. […] Antiviral drugs. If you have herpes or HIV, your doctor may prescribe medicine that keeps a viral infection from getting worse, called an antiviral medicine. […] The sooner you start HIV treatment, the more effective it is. If you take your medicines as directed, it’s possible to lower the viral load in the blood so that it can’t be found. At that point, you won’t spread the virus to sex partners.
#1
https://www.who.int/news-room/fact-sheets/detail/sexually-transmitted-infections-(stis)
Effective treatment is currently available for several STIs. […] Three bacterial (chlamydia, gonorrhoea and syphilis) and one parasitic STIs (trichomoniasis) are generally curable with existing single-dose regimens of antibiotics. […] For herpes and HIV, the most effective medications available are antivirals that can modulate the course of the disease, though they cannot cure the disease. […] For hepatitis B, antivirals can help fighting the virus and slowing damage to the liver. […] AMR of STIs in particular gonorrhoea has increased rapidly in recent years and has reduced treatment options.
#1 Sexually Transmitted Disease (STD) Treatments
https://www.webmd.com/sexual-conditions/std-treatments
Don’t try to treat a sexually transmitted disease, or STD, yourself. These diseases are contagious and serious. You must see a doctor. […] Bacterial STDs can be cured with antibiotics if treatment begins early enough. Viral STDs cannot be cured, but you can manage symptoms with medications. […] If you are given antibiotics to treat a STD, it is important that you take all of the drug prescribed to you, even if the symptoms go away. […] HIV /AIDS: Since AIDS is not curable, treatment focuses on keeping HIV levels in check. Antiretroviral drugs are the standard therapy for HIV infection, and usually you will be given several drugs to take, a so-called drug „cocktail.” […] Chlamydia and Gonorrhea: These STDs are treated with antibiotics. […] Syphilis: Penicillin is the preferred treatment for syphilis. Early treatment is crucial to prevent the bacteria from spreading to and damaging other organs.
#1 Updated Treatment Guidelines for Sexually Transmitted Infections
https://www.uspharmacist.com/article/updated-treatment-guidelines-for-sexually-transmitted-infections
According to the CDC, there were an estimated 26 million new sexually transmitted infections (STIs) in the United States in 2018. […] Updated guidelines for the treatment of STIs were published by the CDC in 2021. […] These guidelines contain the most recent evidence-based information related to prevention of STIs, diagnostic testing, and screening, and they provide updated treatment recommendations for gonorrhea, chlamydia, and trichomoniasis. […] The CDC recommends annual screening for sexually active women younger than age 25 years and for older women at increased risk for infection (new or multiple sexual partners, or a sexual partner with an STI). […] Recommended and alternative treatments for uncomplicated urogenital or rectal gonococcal infections are included in TABLE 1. […] The recommended regimen for treatment of chlamydia in nonpregnant adolescents and adults is doxycycline 100 mg orally twice daily for 7 days.
#1 Updated Treatment Guidelines for Sexually Transmitted Infections
https://www.uspharmacist.com/article/updated-treatment-guidelines-for-sexually-transmitted-infections
The guidelines state that azithromycin is considered an alternative agent because it may be less effective for treating rectal chlamydia, which frequently co-occurs with urogenital infections; if it is used, providers should consider posttreatment evaluation of the treated patient. […] Recommended and alternative treatments for trichomoniasis are summarized in TABLE 2. […] Current sexual partners of persons infected with trichomoniasis should be referred for evaluation and treatment. […] It is important to counsel patients to abstain from sexual activity until after they (and any sexual partners) complete therapy and achieve resolution of any symptoms. […] Although systemic antiviral agents are beneficial for controlling the signs and symptoms of genital herpes as well as preventing recurrence and transmission to sexual partners, patients should be counseled that genital herpes is a chronic infection for which there is no cure.
#1 Sexually Transmitted Infections: Updated Guideline From the CDC | AAFP
https://www.aafp.org/pubs/afp/issues/2022/0500/p553.html
Based on recent evidence, the primary antimicrobial or dose has changed for many STIs. […] Doxycycline continues to be the first-line treatment for chlamydial infections because of consistent effectiveness at urethral, rectal, and pharyngeal sites. […] Ceftriaxone remains the primary treatment for gonorrheal infection, but it now warrants a single 500-mg intramuscular dose or a 1-g intramuscular dose for patients weighing 331 lb (150 kg) or more. […] Patients with chlamydia, gonorrhea, or trichomonas infection should be screened for HIV and syphilis and retested in three months. […] Because of new short-term outcome data suggesting benefit of anaerobic organism treatment, combination treatment with metronidazole, ceftriaxone, and doxycycline is recommended for pelvic inflammatory disease.
#1 Common Sexually Transmitted Infections – (STIs) | familydoctor.org
https://familydoctor.org/common-sexually-transmitted-infections-stis/
Sexually transmitted infections (STIs) are infections spread by sexual contact. These infections are usually passed from person to person through vaginal intercourse. However, they also can be passed through anal sex, oral sex, or skin-to-skin contact. STIs can be caused by viruses, bacteria, or parasites. Many people get STIs but donât know it because they donât have symptoms. Other people have symptoms that can be mild or more bothersome. […] There are many different kinds of STIs. Here is information on some of the most common ones, their symptoms, and their treatments. […] Chlamydia is a bacterial infection that is easily cured. Left untreated it can cause infertility in women. […] Treatment: Antibiotics. Both partners should be treated. […] Gonorrhea is a bacterial infection. Left untreated, it can cause serious health problems. But itâs easily cured.
#1 Diagnosis and Treatment of Sexually Transmitted Infections: A Review – PubMed
https://pubmed.ncbi.nlm.nih.gov/35015033/
Approximately 1 in 5 adults in the US had a sexually transmitted infection (STI) in 2018. […] This review provides an update on the epidemiology, diagnosis, and treatment of gonorrhea, chlamydia, syphilis, Mycoplasma genitalium, trichomoniasis, and genital herpes. […] Ceftriaxone, doxycycline, penicillin, moxifloxacin, and the nitroimidazoles, such as metronidazole, are effective treatments for gonorrhea, chlamydia, syphilis, M genitalium, and trichomoniasis, respectively, but antimicrobial resistance limits oral treatment options for gonorrhea and M genitalium. […] No cure is available for genital herpes. […] Effective STI prevention interventions include screening, contact tracing of sexual partners, and promoting effective barrier contraception. […] Ceftriaxone, doxycycline, penicillin, moxifloxacin, and the nitroimidazoles are effective treatments for gonorrhea, chlamydia, syphilis, Mycoplasma genitalium, and trichomoniasis, respectively, but antimicrobial resistance limits oral therapies for gonorrhea and Mycoplasma genitalium, and no cure is available for genital herpes.
#1 Sexually Transmitted Infections: Updates From the 2021 CDC Guidelines | AAFP
https://www.aafp.org/pubs/afp/issues/2022/0500/p514.html
Ceftriaxone monotherapy is now recommended as the treatment of choice for gonorrhea. Previous CDC guidelines recommended routine dual-therapy regimens in an effort to stave off emerging drug resistance. However, new guidance reflects concerns for antimicrobial stewardship and potential harm from overuse of antibiotics. Thus, co-treatment for gonorrhea with azithromycin or doxycycline is no longer recommended. Test-of-cure is not necessary for people with urogenital or rectal gonorrhea but is recommended 14 days after treatment for patients with pharyngeal infection. […] Doxycycline has emerged as the treatment of choice for chlamydial infections. Recent clinical trials and meta-analyses showed higher rates of microbiologic treatment failure among men and women treated with azithromycin compared with doxycycline. Azithromycin, 1 g in a single oral dose, remains an alternative regimen and is the recommended treatment for pregnant patients. It may also be considered for those with confidentiality concerns or those unable to adhere to seven-day regimens.
#1 Sexually Transmitted Infections: Updates From the 2021 CDC Guidelines | AAFP
https://www.aafp.org/pubs/afp/issues/2022/0500/p514.html
Patients diagnosed with Mycoplasma genitalium should ideally be treated in a two-stage approach using resistance-guided therapy. Initial treatment with doxycycline reduces organism load and facilitates organism clearance, followed by either azithromycin if the Mycoplasma genitalium isolate is macrolide-sensitive or moxifloxacin if the isolate is macrolide-resistant or if resistance testing is unavailable. […] Preferred treatment remains parenteral penicillin G benzathine, 2.4 million units, with a single intramuscular dose given for infection of less than one year’s duration, whereas infection persisting more than one year or of unknown duration should be treated with three consecutive weekly doses of 2.4 million units each. Physicians should ensure that the correct formulation of penicillin G benzathine (Bicillin L-A) is given for intramuscular injection.
#1 Sexually Transmitted Infections: Updates From the 2021 CDC Guidelines | AAFP
https://www.aafp.org/pubs/afp/issues/2022/0500/p514.html
Sexually transmitted infection (STI) rates are increasing for most nationally notifiable disease categories in the United States. The 2021 Centers for Disease Control and Prevention STI guidelines provide several updated, evidence-based testing and treatment recommendations. The recommended treatment for gonorrhea is ceftriaxone monotherapy given intramuscularly, with dosing based on the patient’s body weight. For chlamydia, doxycycline is the preferred treatment. A test-of-cure is recommended for all cases of pharyngeal gonorrhea and for rectal chlamydia if treated with azithromycin. Vaginal trichomoniasis should be treated with a seven-day regimen of metronidazole. Treatment of pelvic inflammatory disease routinely includes metronidazole with doxycycline and an increased dosage of ceftriaxone. Syphilis of less than one year’s duration should be treated with a single dose of intramuscular penicillin G benzathine, 2.4 million units. Syphilis of more than one year’s or unknown duration should be treated with three consecutive weekly doses of intramuscular penicillin G benzathine, 2.4 million units each. A thorough evaluation for otic, ophthalmic, and neurologic symptoms is essential for anyone with syphilis because these complications can occur at any stage and require 10 to 14 days of treatment with intravenous aqueous crystalline penicillin G. Family physicians can reduce STI rates by taking a thorough sexual history, especially in teens and young adults, ordering screening tests and treatment based on the updated Centers for Disease Control and Prevention STI guidelines, and collaborating with public health departments for disease reporting and partner services.
#1 How to Treat a Sexually Transmitted Infection | Sutter Health
https://www.sutterhealth.org/health/how-to-treat-sti
Bacterial and parasitic infections can be cured. […] Viral infections can be treated but not completely cured. […] Chlamydia is usually treated with antibiotics, some of which can be taken for one day, others for seven to 10 days. […] The Centers for Disease Control and Prevention (CDC) recommends a single dose of two antibiotics to cure gonorrhea. […] Syphilis is easily treated with a penicillin injection. […] Treatment often includes draining any abscesses and a lengthy course of antibiotics (at least two weeks). […] Herpes can be treated with antiviral medications at the time of outbreaks and daily antiviral medications to prevent frequent outbreaks. […] HPV can be treated with lotions and liquid nitrogen to freeze the warts. […] Hepatitis B may need prolonged or even lifelong treatment with injectable medications. […] Human immunodeficiency virus (HIV) can be treated and the progression slowed by using a combination of antiviral medications usually a minimum of three to four medications. […] Trichomoniasis is very common and is easily treated with antiparasitic and antibiotic medications.
#1 List of Sexually Transmitted Diseases Medications
https://www.drugs.com/condition/sexually-transmitted-disease.html
Sexually transmitted diseases (STDs, also called sexually transmitted infections [STIs]) are infections that can be passed on while having sex with someone who has the infection. Medications used to treat STDs include antibiotics, antivirals, and antiparasitic treatments. Common STDs and possible treatments include: […] Chlamydia: amoxicillin (Amoxil, Moxatag), azithromycin (Zithromax, Zmax), doxycycline (Acticlate, Doxy-100), or erythromycin (EES, ERY-Tab) […] Gonorrhea: azithromycin (Zithromax, Zmax), doxycycline (Acticlate, Doxy-100), ceftriaxone (Rocephin), or ciprofloxacin (Cipro, Proquin XR) […] Herpes: acyclovir (Sitavig, Zovirax), docosanol (Abreva), famciclovir (Famvir), or valacyclovir (Valtrex) […] Syphilis: doxycycline (Acticlate, Doxy-100), penicillin g benzathine (Bicillin L-A), ceftriaxone (Rocephin), or erythromycin (EES, ERY-Tab) […] Trichomoniasis: metronidazole (Flagyl, Likmez), tinidazole (Tindamax), or secnidazole (Solosec).
#1 Common Sexually Transmitted Infections – (STIs) | familydoctor.org
https://familydoctor.org/common-sexually-transmitted-infections-stis/
Treatment: Antibiotics. Both partners should be treated. […] Herpes is a viral infection that causes painful sores in the genital area. Itâs spread through skin-to-skin contact. Once youâre infected, you have the virus for the rest of your life. […] Treatment: Medicine can treat symptoms but canât cure herpes. If one partner is infected, the other should be checked by a doctor. […] HIV (human immunodeficiency virus) is the virus that causes AIDS (acquired immunodeficiency syndrome). HIV attacks the bodyâs immune system, making you more likely to get sick from other viruses or bacteria. […] Treatment: Medicines can treat symptoms but canât cure HIV or AIDS. If one partner is infected, the other should be checked by a doctor. […] HPV (human papillomavirus) is a family of more than 100 types of viruses. Some donât cause any symptoms. Some types cause genital warts. More aggressive types can cause cancer.
#1 Sexually Transmitted Disease (STD) Treatments
https://www.webmd.com/sexual-conditions/std-treatments
Genital herpes: Once you are infected with genital herpes, the virus remains in your body for life. Antiviral medication (such as Famvir, Valtrex, and Zovirax) can help reduce the length and severity of both the initial and subsequent herpes outbreaks. […] Hepatitis B: The goal of hepatitis B treatment is to stop liver damage by preventing the virus from spreading. There are now five drugs approved for use in hepatitis B: adefovir, entecavir, interferon alpha, lamivudine, and pegylated interferon. […] Trichomoniasis: Infection by this organism is treated with the drug metronidazole, and the cure rate is about 90%.
#1 What are the treatments for sexually transmitted diseases and sexually transmitted infections (STDs/STIs)? | NICHD – Eunice Kennedy Shriver National Institute of Child Health and Human Development
http://www.nichd.nih.gov/health/topics/stds/conditioninfo/treatments
STDs/STIs caused by bacteria or parasites can be treated with antibiotics. These antibiotics are most often given by mouth (orally). However, sometimes they are injected or applied directly to the affected area. […] The treatments, complications, and outcomes for viral STIs depend on the particular virus (HIV, genital herpes, human papillomavirus, hepatitis, or cytomegalovirus). Treatments can reduce the symptoms and the progression of most of these infections. […] Individuals with HIV need to take special antiretroviral drugs that control the amount of virus they carry. These drugs, called highly active antiretroviral therapy, or HAART, can help people live longer, healthier lives and can prevent onward transmission of HIV to others. […] Getting tested and treated for STIs is especially important for pregnant women because some STIs may be passed on during pregnancy or delivery. […] Whatever the infection, and regardless of how quickly the symptoms resolve after beginning treatment, the infected person and their partner(s) must take all of the medicine prescribed by the health care provider to ensure that the STI is completely treated.
#1 Sexually Transmitted Infections (STIs) > Fact Sheets > Yale Medicine
https://www.yalemedicine.org/conditions/sexually-transmitted-diseases
Treatment depends on the cause of infection, and can include antibiotics or antiviral drugs. […] Treatment for STIs varies depending on the cause of the infection. For pregnant women, prompt treatment can prevent or reduce the risk of infection spreading to their baby. Options include: […] Antibiotics: These are used to treat STIs caused by bacteria. This category includes gonorrhea, syphilis, and chlamydia. Antibiotics are also used to treat trichomoniasis, which is caused by a parasite. Most of the medicines are oral, though intramuscular injections are used for gonorrhea (which has a growing problem of antibiotic resistance) and for syphilis. […] Antiviral drugs: STIs caused by some viral infections can’t be cured, but they can still be managed with antiviral drugs. For HIV, antiviral drugs can control the virus and allow people to live longer, healthier lives. For patients with HIV, effective therapies are available that can reduce the amount of HIV in the blood to „undetectable levels,” meaning the viral load is so low that it cannot be detected by lab tests. When HIV is undetectable in the blood, the virus cannot be sexually transmitted to others. This is often referred to by the phrase „undetectable = untransmittable,” or U=U. For herpes, antiviral drugs can lower the risk of recurrences and reducebut not eliminatethe risk of transmitting the virus to others.
#1 Sexually transmitted infections – Knowledge @ AMBOSS
https://www.amboss.com/us/knowledge/sexually-transmitted-infections/
Chancroid and granuloma inguinale (donovanosis) are rare in the United States. If there is diagnostic uncertainty or genital ulcers persist, immediately refer patients to centers with experience diagnosing and treating chancroid, granuloma inguinale, and LGV. […] Sexual partners must be treated simultaneously to avoid reinfections. […] EPT is recommended for all sexual partners of patients with gonorrhea and/or chlamydia if the partner is unlikely to seek medical evaluation. […] Offer HIV testing to partners of all patients diagnosed with STIs. […] Recommend adherence to screening guidelines for STIs. […] Routine serological screening for herpes simplex virus 2 in asymptomatic individuals is not recommended.
#1 Expedited Partner Therapy – EPT | Washington State Department of Health
https://doh.wa.gov/you-and-your-family/illness-and-disease-z/sexually-transmitted-infections-sti/expedited-partner-therapy-ept
Expedited Partner Therapy provides for the treatment of sex partners of infected individuals. This treatment can be offered without requiring partners to be tested or seen by health care providers. […] All partners of patients who test positive for Chlamydia or Gonorrhea should be treated as if they are infected. If a physician takes responsibility to ensure partner treatment, the provider should examine and treat all of the persons the patient had sex with in the 60 days prior to the date the patient was tested. If this is not possible, patients may be given medication to give to their sex partners.
#1 Get Sexually Transmitted Infections Treatment | Cleveland Clinic
https://my.clevelandclinic.org/services/sexually-transmitted-infections-treatment
In expedited partner therapy (EPT), we treat both you and your partner for certain STIs without having to examine your partner first. This therapy helps prevent you and your partner from re-infecting each other. […] If you think you might have a sexually transmitted infection, its important not to let fear or embarrassment stop you from getting things checked out and treated. Our specialists will respect your privacy and offer personalized testing and treatment of any STI for you and your sexual partner(s). Were here to help you heal and feel good again in a judgment-free atmosphere.
#1 Sexually transmitted diseases (STDs) – Diagnosis and treatment – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/sexually-transmitted-diseases-stds/diagnosis-treatment/drc-20351246
If you’ve had a sexually transmitted infection, ask your health care professional how long after treatment you need to be retested. Getting retested will ensure that the treatment worked and that you haven’t been reinfected. […] If tests show that you have an STD, you need to tell your sex partners. […] Official, confidential partner notification can help limit the spread of sexually transmitted infections. This is very important for syphilis and HIV.
#1 STD | Alabama Department of Public Health (ADPH)
https://www.alabamapublichealth.gov/std/index.htmL
Sexually transmitted diseases (STDs), also known as sexually transmitted infections (STIs), are very common. […] The Alabama Department of Public Healths STD Division focuses on clinical and field services for STD testing, treatment, education, and prevention. […] Adequate treatment of people infected with an STD. […] The DIS provides support for STD testing, infected patient and sex partners referral for treatment, and strategies to prevent the spread of STIs. […] Treating syphilis in pregnant women early can prevent premature birth, stillbirth, infant death, and other severe newborn complications.
#1 Sexually transmitted infections (STIs)
https://www.rch.org.au/clinicalguide/guideline_index/sexually_transmitted_infections_stis/
If high index of suspicion, treat without waiting for lab results […] No sexual contact for 7 days after treatment is administered […] No sexual contact with partners from the last 6 months, until the partners have been tested and treated if necessary […] Complete other STI screening […] Follow-up after 1 week with GP or other health professional to confirm symptom resolution and contact tracing complete, provide sexual health education and prevention […] Test of cure not routinely recommended, however, re-testing to detect re-infection at 3 months is recommended […] If high index of suspicion, treat without waiting for lab results […] No sexual contact for 7 days after treatment is administered […] No sexual contact with partners from the last 2 months, until the partners have been tested and treated if necessary
#1 Sexually transmitted diseases – Mayo Clinic Health System
https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/sexually-transmitted-diseases-what-you-need-to-know
You probably remember having some form of safe sex talk with your parents or other adults. […] It’s equally important to discuss the topic of sexually transmitted infections (STIs). […] Chlamydia is treated easily with antibiotics, but if all sexual partners are not treated, the infection will continue to spread or reinfection can occur. […] To help ensure all partners receive medication for the infection, partner treatment, called expedited partner therapy, can be prescribed. […] Genital herpes can also be contracted or passed without being aware of the infection because there may not be any signs or symptoms of the virus. […] While symptoms can be treated, the virus remains in the body. […] Making informed decisions about your partner and choosing when to be sexually active are important in preventing your exposure to STIs. […] Condoms are still the best barrier protection against STIs. […] It’s recommended that all people ages 9â45 get the HPV vaccine to prevent contracting HPV, a sexually transmitted virus that can cause cancer.
#1 Sexually transmitted infections (STI) in children and teens – Treatment and Prevention – Children’s Health
https://www.childrens.com/specialties-services/conditions/sexually-transmitted-infection
If your child is sexually active, or considering becoming sexually active, they needs to learn how to prevent STIs (also called sexually transmitted diseases – STD) and the importance of testing and prompt treatment if they are at risk for an STI. […] The best way for your child to prevent STIs is to avoid sexual activity (abstinence). At Childrens Health, we will explain the potential consequences of sexual activity especially risky or unprotected sex. […] If your child is diagnosed with an STI, treatment depends on the infection and may include: […] Antibiotics for chlamydia, gonorrhea, or syphilis […] Anti-parasitic medication for trichomoniasis […] Antiviral medications to treat and prevent outbreaks of, but not cure, herpes […] Combination of antiviral medications to treat, but not cure, HIV […] Creams to get rid of genital warts, but not the HPV virus.
#1 Sexually Transmitted Infections
https://www.hiv.gov/hiv-basics/staying-in-hiv-care/other-related-health-issues/sexually-transmitted-diseases
The only 100% effective way to avoid getting other STIs is to not have vaginal, anal, or oral sex. […] Doxy PEP is a way to prevent getting an STI. It involves taking a dose of the antibiotic doxycycline ideally within 24 hours but no later than 72 hours after condomless oral, anal, or vaginal sex. […] Doxy PEP has been proven to reduce your chances of getting a bacterial STI (syphilis, chlamydia, and gonorrhea) by about two-thirds. […] If you are sexually active, getting tested for STIs is one of the most important things you can do to protect your health and your partner’s health. […] Many STIs are curable and all are treatable. If either you or your partner is infected with an STI that can be cured, both of you need to start treatment immediately to avoid getting re-infected.
#1 Preventing Sexually Transmitted Infections (STIs) after Unprotected Sex | Patient Care
https://weillcornell.org/news/preventing-sexually-transmitted-infections-stis-after-unprotected-sex
Its called PEP, but it isnt a pep pill or any other type of stimulant. Rather, PEP stands for post-exposure prophylaxismedication you can take shortly after youve been exposed to a sexually transmitted infection (STI). […] In four clinical trials, doxycycline, a decades-old antibiotic, has been showing promise in protecting men who have sex with men and transgender women from contracting chlamydia, gonorrhea and syphylis after condomless sex. […] The overall conclusion of these studies is that doxycycline 200mg (two 100mg capsules) taken within 72 hours of condomless sex reduces a persons risk of acquiring gonorrhea, chlamydia or syphilis by 47 to 66 percent. […] Currently, the New York City Department of Health and Mental Hygiene recommends that doctors discuss doxyPEP with patients at risk of contracting one of the above-mentioned STIs, weigh the pros and cons and engage in joint decision-making.
#1 Sexually transmitted infections: What doctors wish patients knew | American Medical Association
https://www.ama-assn.org/delivering-care/public-health/sexually-transmitted-infections-what-doctors-wish-patients-knew
And, over time, gonorrhea and chlamydia can lead to pelvic inflammatory disease and infertility in women, so it is really important that we get people tested and treated as best we can, Dr. Zucker added, noting you should be tested every three to six months if you’re sexually active with a new partner. […] For HPV, getting vaccinated to prevent getting most strains of HPV that can cause cancer is incredibly effective not just for preventing cervical cancer in women, but also for throat and rectal cancer in men, Dr. Zucker said, emphasizing that everybody benefits from HPV vaccination. […] PrEP is an incredible intervention, Dr. Zucker noted. If you take one pill once a dayor for men who have sex with men, take a pill before and after sexyou can with almost 100% success prevent HIV. […] It really is an underused intervention for people who may be exposed to HIV, he added. […] You should not hesitate to talk with your doctor about sexually transmitted infections and sex in general, Dr. Zucker said.
#1 Sexually transmitted diseases (STDs) – Symptoms and causes – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/sexually-transmitted-diseases-stds/symptoms-causes/syc-20351240
Sexually transmitted infections can be caused by: […] Sexually transmitted infection symptoms may appear a few days after exposure. But it may take years before you have any noticeable problems, depending on what’s causing the STI. […] See a health care professional immediately if: […] Make an appointment with a health care professional: […] Your health care professional will prescribe these medicines for HIV prevention only if you don’t already have HIV. You’ll need an HIV test before you start taking PrEP and then every three months as long as you’re taking it. […] According to the CDC, if you use Truvada daily, you can lower your risk of getting HIV from sex by about 99%. And you can lower your risk of getting HIV from injection drug use by more than 74%. […] Research suggests that Descovy is also effective in lowering the risk of getting HIV from sex. But Descovy hasn’t been studied in people who have receptive vaginal sex. Using added prevention, such as condoms, can lower your risk even more and prevent other STIs.
#1 Sexually Transmitted Infections (STIs): Diagnosis, Treatment and Prevention | Nationwide Children’s Hospital
https://www.nationwidechildrens.org/conditions/sexually-transmitted-infections
If you have an STI, it is important to tell any partners you’ve had in the past 3 months. They will need to be tested and treated, as well. […] After being treated for an STI, do not have sex at all for the next week. […] AVOID SEXUAL CONTACT until one week after you and your partner are both finished with the antibiotic treatments.
#1 Sexually transmitted infections (STIs)
https://www.nhs.uk/conditions/sexually-transmitted-infections-stis/
Most sexually transmitted infections (STIs) need treatment. The treatment you have will depend on which STI you have. […] Many STIs are treated with antibiotics. […] Always finish the course of treatment prescribed for you or it may not work properly. […] Do not have sex (including oral sex) until you and your partner or partners have finished treatment. […] If you need treatment, its important to tell your current and previous sexual partner (or partners). Sexual health clinics may be able to help you contact them anonymously.
#1 Sexually Transmitted Infections (STI, STD): Causes, Symptoms, and Treatment
https://patient.info/sexual-health/sexually-transmitted-infections-leaflet
A sexually transmitted infection (STI) is an infection that can be passed from person to person when having sex. […] The treatment that you will be offered depends on which STI is found. For example, a short course of antibiotics can usually clear away chlamydia, gonorrhoea, syphilis and trichomonas. A cream or lotion can clear pubic lice and scabies. Topical treatments can usually clear most anogenital warts. Treatments for genital herpes, hepatitis B, hepatitis C and HIV are more involved and complex. You will be given advice about what treatment options you have and given time to ask questions. […] If you are prescribed antibiotics then it is important to finish the full course of tablets, or else the infection may not be fully cleared. If you develop side-effects then seek advice from the GUM clinic or from your GP as to what to do. Do not simply stop taking the medication. For some infections you will be asked to return after a course of treatment to check that the infection has gone. […] Do not have sex again until the time advised by the clinic. Depending on the infection, this may be for a certain length of time after treatment has finished or it may be until you are given the all clear from a repeat test. The aim is to prevent you from passing on the infection to others.
#1 Prevention and treatment of sexually transmitted infections in high-risk individuals, including patients with HIV infection | Enfermedades Infecciosas y MicrobiologÃa ClÃnica (English Edition)
https://www.elsevier.es/en-revista-enfermedades-infecciosas-microbiologia-clinica-english-428-articulo-prevention-treatment-sexually-transmitted-infections-S2529993X19300012
In general, there is no difference in the treatment of choice for STIs between people living with HIV and people without HIV. However, there are some exceptions. […] Table 5 shows the preferred treatment regimens for the main STIs according to the latest versions of the clinical guidelines. […] The use of suitable microbiological tests is key to effective management of STIs. […] The spectrum of diagnostic tests in microbiology used in STI ranges from direct microscopy, culture, antigen detection and serology, to the detection of genomic material. […] The management of STIs is made easier and more effective by access to a rapid diagnosis, as the patient can often be dealt with in a single consultation. […] The rapid tests also enable patients to receive early, specific treatment, avoiding unnecessary and inadequate antibiotic therapy and minimising the chain of transmission, which helps prevent new cases.
#1 Sexually Transmitted Infections: Updated Guideline From the CDC | AAFP
https://www.aafp.org/pubs/afp/issues/2022/0500/p553.html
Most states permit expedited partner therapy, including provision of packaged medications or prescriptions without evaluation, to limit the spread of STIs. […] For chlamydial infections affecting the urethra, rectum, or pharynx, doxycycline, 100 mg orally twice daily for seven days, is most effective. […] For gonorrheal infection, ceftriaxone, 500 mg intra-muscularly as a single dose, is recommended for most people, with azithromycin cotreatment no longer recommended. […] For pelvic inflammatory disease, metronidazole is added to ceftriaxone and doxycycline treatment to eradicate anaerobic organisms. […] Evidence-based prevention and treatment of sexually transmitted infections (STIs) continue to evolve. […] Expedited partner therapy allows clinicians to treat sex partners of their patients, without seeing the partners directly, with patient-facilitated delivery of prepackaged medication or prescription.
#1 Syndromic Management of Sexually Transmitted Infections – PAHO/WHO | Pan American Health Organization
https://www.paho.org/en/topics/sexually-transmitted-infections/syndromic-management-sexually-transmitted-infections
Many healthcare facilities in developing countries lack the equipment and trained personnel required for etiological diagnosis of STIs (using laboratory tests to identify the causative agent). Where no laboratories or point-of-care diagnostic tests are available, a syndrome-based approach to the management of STI patients should be promoted. […] With the syndromic management approach, accessible, affordable, and effective management of individuals with STIs relies on utilization of flowcharts (algorithms) for each STI syndrome. […] Treatment based on this approach is chosen to cover the major pathogens responsible for the syndromes in the specific geographical area. […] Syndromic case management enables all trained first-line service providers to diagnose an STI syndrome and treat patients on the patients first visit, helping to prevent the further spread of STIs where etiological diagnosis is not available.
#1 Prevention and treatment of sexually transmitted infections in high-risk individuals, including patients with HIV infection | Enfermedades Infecciosas y MicrobiologÃa ClÃnica (English Edition)
https://www.elsevier.es/en-revista-enfermedades-infecciosas-microbiologia-clinica-english-428-articulo-prevention-treatment-sexually-transmitted-infections-S2529993X19300012
The recommendations in Spain for PrEP have been established for individuals whose characteristics mean they belong to a high-risk group with an HIV incidence of two cases/100 person-years or higher; falling into this category are MSM and transgender women who also meet any of the following criteria. […] Post-exposure prophylaxis (PEP) after risky sexual behaviour (RSB) consists of the administration of antiretroviral therapy (ART) at an early stage for a limited period of 28 days to prevent HIV infection. […] Rapid microbiological diagnosis of STIs and immediate treatment are the best way to break the chain of transmission. […] Accurate clinical and microbiological diagnoses are essential for the best clinical-epidemiological management of STIs. […] The implementation of rapid response microbiological diagnostic systems enables early treatment to interrupt the chain of transmission and prevent major clinical complications.
#2 Treatment & Care
https://www.who.int/teams/global-hiv-hepatitis-and-stis-programmes/stis/treatment-care
Correct and effective treatment of sexually transmitted infections (STIs) ideally given and taken on the same day, at the first contact between patients and health-care providers is an important public health measure in the control of STIs, since it endeavours to break the chain of transmission of the infection without delay. […] Countries should establish and use national standardized treatment protocols for STIs. Standardization ensures that all patients receive appropriate and adequate treatment at all levels of the health-care service. […] The purpose of comprehensive STI case management is to provide treatment, obtain cure, reduce infectiveness, reduce the risk of developing complications from STIs, and reduce or prevent future risk-taking behaviour. […] Thus, effective case management consists not only of antimicrobial therapy to obtain cure and reduce infectiousness, but also the comprehensive assessment and care of a patients sexual and reproductive health and that of their sex partners.
#2 What are the treatments for sexually transmitted diseases and sexually transmitted infections (STDs/STIs)? | NICHD – Eunice Kennedy Shriver National Institute of Child Health and Human Development
http://www.nichd.nih.gov/health/topics/stds/conditioninfo/treatments
STDs/STIs caused by bacteria or parasites can be treated with antibiotics. These antibiotics are most often given by mouth (orally). However, sometimes they are injected or applied directly to the affected area. […] The treatments, complications, and outcomes for viral STIs depend on the particular virus (HIV, genital herpes, human papillomavirus, hepatitis, or cytomegalovirus). Treatments can reduce the symptoms and the progression of most of these infections. […] Individuals with HIV need to take special antiretroviral drugs that control the amount of virus they carry. These drugs, called highly active antiretroviral therapy, or HAART, can help people live longer, healthier lives and can prevent onward transmission of HIV to others. […] Getting tested and treated for STIs is especially important for pregnant women because some STIs may be passed on during pregnancy or delivery. […] Whatever the infection, and regardless of how quickly the symptoms resolve after beginning treatment, the infected person and their partner(s) must take all of the medicine prescribed by the health care provider to ensure that the STI is completely treated.
#2 Sexually Transmitted Infections: Updated Guideline From the CDC | AAFP
https://www.aafp.org/pubs/afp/issues/2022/0500/p553.html
Based on recent evidence, the primary antimicrobial or dose has changed for many STIs. […] Doxycycline continues to be the first-line treatment for chlamydial infections because of consistent effectiveness at urethral, rectal, and pharyngeal sites. […] Ceftriaxone remains the primary treatment for gonorrheal infection, but it now warrants a single 500-mg intramuscular dose or a 1-g intramuscular dose for patients weighing 331 lb (150 kg) or more. […] Patients with chlamydia, gonorrhea, or trichomonas infection should be screened for HIV and syphilis and retested in three months. […] Because of new short-term outcome data suggesting benefit of anaerobic organism treatment, combination treatment with metronidazole, ceftriaxone, and doxycycline is recommended for pelvic inflammatory disease.
#2 Sexually Transmitted Infections: Updates From the 2021 CDC Guidelines | AAFP
https://www.aafp.org/pubs/afp/issues/2022/0500/p514.html
Ceftriaxone monotherapy is now recommended as the treatment of choice for gonorrhea. Previous CDC guidelines recommended routine dual-therapy regimens in an effort to stave off emerging drug resistance. However, new guidance reflects concerns for antimicrobial stewardship and potential harm from overuse of antibiotics. Thus, co-treatment for gonorrhea with azithromycin or doxycycline is no longer recommended. Test-of-cure is not necessary for people with urogenital or rectal gonorrhea but is recommended 14 days after treatment for patients with pharyngeal infection. […] Doxycycline has emerged as the treatment of choice for chlamydial infections. Recent clinical trials and meta-analyses showed higher rates of microbiologic treatment failure among men and women treated with azithromycin compared with doxycycline. Azithromycin, 1 g in a single oral dose, remains an alternative regimen and is the recommended treatment for pregnant patients. It may also be considered for those with confidentiality concerns or those unable to adhere to seven-day regimens.
#2 How to Treat a Sexually Transmitted Infection | Sutter Health
https://www.sutterhealth.org/health/how-to-treat-sti
Bacterial and parasitic infections can be cured. […] Viral infections can be treated but not completely cured. […] Chlamydia is usually treated with antibiotics, some of which can be taken for one day, others for seven to 10 days. […] The Centers for Disease Control and Prevention (CDC) recommends a single dose of two antibiotics to cure gonorrhea. […] Syphilis is easily treated with a penicillin injection. […] Treatment often includes draining any abscesses and a lengthy course of antibiotics (at least two weeks). […] Herpes can be treated with antiviral medications at the time of outbreaks and daily antiviral medications to prevent frequent outbreaks. […] HPV can be treated with lotions and liquid nitrogen to freeze the warts. […] Hepatitis B may need prolonged or even lifelong treatment with injectable medications. […] Human immunodeficiency virus (HIV) can be treated and the progression slowed by using a combination of antiviral medications usually a minimum of three to four medications. […] Trichomoniasis is very common and is easily treated with antiparasitic and antibiotic medications.
#2 Sexually Transmitted Infections (STIs): Sexually Transmitted Diseases (STDs)
https://my.clevelandclinic.org/health/diseases/9138-sexually-transmitted-diseases–infections-stds–stis
A sexually transmitted infection (sexually transmitted disease) is a serious condition that can develop after you have sex. The good news is that most STI treatments can cure the infection, but not all types. […] STIs are serious illnesses that need treatment. Some, like the human immunodeficiency virus (HIV), have no cure and can be life-threatening without treatment. […] If you have an STI, it’s important to visit a healthcare provider to receive treatment. Some STIs are curable. […] The goal of sexually transmitted infection (sexually transmitted disease) treatment is to: Cure many (not all) STIs. Lessen your symptoms. Reduce your likelihood of spreading the infection. Help you get healthy and stay healthy. […] Treatment for STIs could include taking medications like: Antibiotics. Antivirals.
#2 Sexually Transmitted Infections: Updated Guideline From the CDC | AAFP
https://www.aafp.org/pubs/afp/issues/2022/0500/p553.html
Most states permit expedited partner therapy, including provision of packaged medications or prescriptions without evaluation, to limit the spread of STIs. […] For chlamydial infections affecting the urethra, rectum, or pharynx, doxycycline, 100 mg orally twice daily for seven days, is most effective. […] For gonorrheal infection, ceftriaxone, 500 mg intra-muscularly as a single dose, is recommended for most people, with azithromycin cotreatment no longer recommended. […] For pelvic inflammatory disease, metronidazole is added to ceftriaxone and doxycycline treatment to eradicate anaerobic organisms. […] Evidence-based prevention and treatment of sexually transmitted infections (STIs) continue to evolve. […] Expedited partner therapy allows clinicians to treat sex partners of their patients, without seeing the partners directly, with patient-facilitated delivery of prepackaged medication or prescription.
#2 Sexually transmitted infections (STIs)
https://www.nhs.uk/conditions/sexually-transmitted-infections-stis/
Most sexually transmitted infections (STIs) need treatment. The treatment you have will depend on which STI you have. […] Many STIs are treated with antibiotics. […] Always finish the course of treatment prescribed for you or it may not work properly. […] Do not have sex (including oral sex) until you and your partner or partners have finished treatment. […] If you need treatment, its important to tell your current and previous sexual partner (or partners). Sexual health clinics may be able to help you contact them anonymously.
#2 Sexually transmitted infections (STIs)
https://www.rch.org.au/clinicalguide/guideline_index/sexually_transmitted_infections_stis/
If high index of suspicion, treat without waiting for lab results […] No sexual contact for 7 days after treatment is administered […] No sexual contact with partners from the last 6 months, until the partners have been tested and treated if necessary […] Complete other STI screening […] Follow-up after 1 week with GP or other health professional to confirm symptom resolution and contact tracing complete, provide sexual health education and prevention […] Test of cure not routinely recommended, however, re-testing to detect re-infection at 3 months is recommended […] If high index of suspicion, treat without waiting for lab results […] No sexual contact for 7 days after treatment is administered […] No sexual contact with partners from the last 2 months, until the partners have been tested and treated if necessary
#2 Prevention and treatment of sexually transmitted infections in high-risk individuals, including patients with HIV infection | Enfermedades Infecciosas y MicrobiologÃa ClÃnica (English Edition)
https://www.elsevier.es/en-revista-enfermedades-infecciosas-microbiologia-clinica-english-428-articulo-prevention-treatment-sexually-transmitted-infections-S2529993X19300012
The recommendations in Spain for PrEP have been established for individuals whose characteristics mean they belong to a high-risk group with an HIV incidence of two cases/100 person-years or higher; falling into this category are MSM and transgender women who also meet any of the following criteria. […] Post-exposure prophylaxis (PEP) after risky sexual behaviour (RSB) consists of the administration of antiretroviral therapy (ART) at an early stage for a limited period of 28 days to prevent HIV infection. […] Rapid microbiological diagnosis of STIs and immediate treatment are the best way to break the chain of transmission. […] Accurate clinical and microbiological diagnoses are essential for the best clinical-epidemiological management of STIs. […] The implementation of rapid response microbiological diagnostic systems enables early treatment to interrupt the chain of transmission and prevent major clinical complications.
#2 Preventing Sexually Transmitted Infections (STIs) after Unprotected Sex | Patient Care
https://weillcornell.org/news/preventing-sexually-transmitted-infections-stis-after-unprotected-sex
Its called PEP, but it isnt a pep pill or any other type of stimulant. Rather, PEP stands for post-exposure prophylaxismedication you can take shortly after youve been exposed to a sexually transmitted infection (STI). […] In four clinical trials, doxycycline, a decades-old antibiotic, has been showing promise in protecting men who have sex with men and transgender women from contracting chlamydia, gonorrhea and syphylis after condomless sex. […] The overall conclusion of these studies is that doxycycline 200mg (two 100mg capsules) taken within 72 hours of condomless sex reduces a persons risk of acquiring gonorrhea, chlamydia or syphilis by 47 to 66 percent. […] Currently, the New York City Department of Health and Mental Hygiene recommends that doctors discuss doxyPEP with patients at risk of contracting one of the above-mentioned STIs, weigh the pros and cons and engage in joint decision-making.