New Directions In STD Treatment - University of Hawaii
New Directions In STD Treatment - University of Hawaii New Directions In STD Treatment - University of Hawaii
Trichomoniasis Issues � Diagnosis on Pap test lacks specificity; recommend confirm with culture if patient is at low risk � New point of care tests have better sensitivity but FP in lower prevalence population � OSOM Trichomonas Rapid Test and Affirm TM VP III � Culture is the most sensitive and specific and should be done if wet mount is negative and Trichomoniasis is suspected � New treatment: � ADD tinidazole 2 g po x 1 � Higher cost but better tolerated � New management of treatment failure (after metro 2 g po x 1) and Metronidazole-resistant trichomonas
Tinidazole: A New Treatment Option � Second generation 5-nitroimidazole �92%-100% effectiveness for trichomoniasis �Contraindicated in pregnancy (category C) � Advantages versus Metronidazole � Greater tolerability (approx. ½ incidence of nausea, vomiting and other GI side effects) � Longer duration of action (t1/2 of 12-14 hrs vs 6-7 hrs) � Greater in vitro potency against protozoa and anaerobes � Effective in metronidazole-resistant trichomoniasis � 92% (22/24) cure rate in largest report � Enhanced penetration in genital tissues
- 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 and 62: Cervicitis - Diagnostic Issues �
- Page 63 and 64: Pelvic Inflammatory Disease Issues
- Page 65 and 66: PID: Oral Treatment Regimens Oral r
- Page 67: Vaginitis Trichomonas Bacterial Vag
- Page 71 and 72: Proposed Management Trichomoniasis
- Page 73 and 74: BV Treatment Recommended regimens:
- Page 75: STD Resources California STD/HIV Pr
Trichomoniasis Issues<br />
� Diagnosis on Pap test lacks specificity; recommend<br />
confirm with culture if patient is at low risk<br />
� <strong>New</strong> point <strong>of</strong> care tests have better sensitivity but FP<br />
in lower prevalence population<br />
� OSOM Trichomonas Rapid Test and Affirm TM VP III<br />
� Culture is the most sensitive and specific and should<br />
be done if wet mount is negative and Trichomoniasis<br />
is suspected<br />
� <strong>New</strong> treatment:<br />
� ADD tinidazole 2 g po x 1<br />
� Higher cost but better tolerated<br />
� <strong>New</strong> management <strong>of</strong> treatment failure (after metro 2 g<br />
po x 1) and Metronidazole-resistant trichomonas
Change language