HWN Suggests

CDC updates guidelines on treatment of sexually transmitted infections

The new guidelines recommend doxycycline 100 milligrams (mg) orally twice daily for seven days as first-line chlamydial infection treatment for AYA. For patients with a doxycycline allergy or pregnancy, alternatives include azithromycin 1 gram (g) orally in a single dose or levofloxacin 500 mg orally once daily for seven days.

Studies have shown doxycycline is more efficacious than azithromycin, especially for extragenital sites. If doxycycline non-adherence is a concern, azithromycin is an option. If azithromycin is used, post-treatment evaluation and testing should be considered, especially with rectal infections.

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Articles of Interest

Treatment of Chlamydial Infections

Sexually transmitted infections (STIs) are a major health problem with an estimated burden of disease transmission as high as one million new cases per day globally. Chlamydia trachomatis, a member of the genus Chlamydia, is one of the most common and curable causative agents of STIs.

Updates in STI Care

For a simple chlamydial infection, the recommended treatment is 100 mg of doxycycline PO BID for 7 days. For patients with concern for treatment compliance, you can consider a single dose of azithromycin. For a simple gonorrheal infection, the recommended treatment is 500 mg of IM ceftriaxone (note: this is double the previously recommended dose). Co-treatment with azithromycin or doxycycline for gonorrheal infections where chlamydia co-infection has been excluded is no longer recommended. Given rising resistance among strains of both gonorrhea and chlamydia, if patients do not have symptom resolution within 3-5 days, it is recommended that they get re-tested and possibly re-treated with alternative regimens.

Resources

CDC

Doxycycline 100 mg orally twice a day for 7 days.