New Directions In STD Treatment - University of Hawaii

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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
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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
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Sexual History Taking: The 5 P’s
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Recommend Nucleic Acid Amplificatio
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Percent Screened Estimated Chlamydi
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STD Screening for MSM STD Site Type
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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 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
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New Directions In STD Treatment - University of Hawaii

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