New Directions In STD Treatment - University of Hawaii

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Cervicitis – Treatment Issues � New age- and risk-based empiric treatment � Presumptive treatment for CT: � Age 25 or younger � STD risk in older women: new/multiple partners, unprotected sex � Especially if follow-up unlikely or non-NAAT test used � Presumptive treatment for GC: � High prevalence (>5%) � Treat BV if present
Pelvic Inflammatory Disease Issues � Newest etiologic agent: Mycoplasma genitalium � Pathogenesis unclear � No recommendation for Mg testing � If no evidence of cervicitis and no WBCs on wet mount the diagnosis of PID is unlikely � Modify minimal criteria for presumptive treatment: � CMT OR uterine tenderness OR adnexal tenderness � Clarify use of metronidazole*: � Treatment to cover anarobes should be considered � If BV is present or cannot be ruled out, add metronidazole* � Azithromycin treatment mentioned “outside the box” * Discussed at the 2006 Guidelines Meeting
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New Directions in STD Treatment: Hi
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CDC 2006 STD Treatment Guidelines D
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Challenging Management Dilemmas in
Page 7 and 8:
Sexual History Taking: The 5 P’s
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Recommend Nucleic Acid Amplificatio
Page 11 and 12: Percent Screened Estimated Chlamydi
Page 13 and 14: STD Screening for MSM STD Site Type
Page 15 and 16: Prevalence of rectal chlamydia and
Page 17 and 18: Prevalence of pharyngeal chlamydia
Page 19 and 20: C. trachomatis NAAT Testing …not
Page 21 and 22: Chlamydia Treatment in Pregnancy Re
Page 23 and 24: Percent 16 14 12 10 Infection Durin
Page 25 and 26: Provider Barriers to PDPT, CA 2002
Page 27 and 28: Gonorrhea Screening in Females �
Page 29 and 30: Percent of Neisseria gonorrhoeae Is
Page 31 and 32: Gonorrhea Treatment of Urogenital I
Page 33 and 34: Lymphogranuloma Venereum (LGV) C. t
Page 35 and 36: LGV Proctocolitis: Serologic Diagno
Page 37 and 38: Phil and the Penis on the Go
Page 39 and 40: The Three “R”s of Syphilis �
Page 41 and 42: Latent Syphilis � No clinical man
Page 43 and 44: Syphilis EIA Tests �Treponemal te
Page 45 and 46: Criteria for CSF Examination � Ne
Page 47 and 48: Syphilis Resistant to Azithromycin!
Page 51 and 52: HSV Issues � Role of type-specifi
Page 53 and 54: Rates of Transmission of HSV-2 to S
Page 55 and 56: Genital Herpes - Treatment Issues
Page 57 and 58: HPV Issues � Clarify uses of HPV
Page 59 and 60: Issues Regarding Anal Cancer Screen
Page 61: Cervicitis - Diagnostic Issues �
Page 65 and 66: PID: Oral Treatment Regimens Oral r
Page 67 and 68: Vaginitis Trichomonas Bacterial Vag
Page 69 and 70: Tinidazole: A New Treatment Option
Page 71 and 72: Proposed Management Trichomoniasis
Page 73 and 74: BV Treatment Recommended regimens:
Page 75: STD Resources California STD/HIV Pr
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New Directions In STD Treatment - University of Hawaii

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