Drug Treatment Of Common Stds: Part I Herpes Syphilis Urethritis Chlamydia And Gonorrhea
CAROL WOODWARD, PHARM.D., West Virginia University Hospitals, Morgantown, West Virginia
MELANIE A. FISHER, M.D., M.SC., West Virginia University, Morgantown, West Virginia
Am Fam Physician. 1999 Oct 1 60:1387-1394.
This is Part I of a two-part article on drug treatment of common sexually transmitted diseases. Part II, Vaginal Infections, Pelvic Inflammatory Disease and Genital Warts, will appear in the next issue of AFP.
Several advances have been made in the treatment of sexually transmitted diseases . These advances have been incorporated into the 1998 Guidelines for the Treatment of Sexually Transmitted Diseases, published by the Centers for Disease Control and Prevention .1
Highly effective single-dose oral therapies are now available for most common curable STDs. Single-dose regimens may be used for the treatment of chancroid, nongonococcal urethritis, uncomplicated gonococcal infections, bacterial vaginosis, trichomoniasis, candidal vaginitis and chlamydial infections.
Improved therapies are now available for the treatment of genital herpes and human papillomavirus infections. New regimens have been approved for the use of acyclovir in the treatment of genital herpes. In addition, two new antiviral agents, valacyclovir and famciclovir , have been labeled for the treatment of genital herpes. Patient-applied therapies are now recommended for management of HPV.
Drug Treatment Of Common Stds: Part Ii Vaginal Infections Pelvic Inflammatory Disease And Genital Warts
CAROL WOODWARD, PHARM.D., West Virginia University Hospitals, Morgantown, West Virginia West Virginia
MELANIE A. FISHER, M.D., M.SC., University, Morgantown, West Virginia
Am Fam Physician. 1999 Oct 15 60:1716-1722.
This is Part II of a two-part article on drug treatment of sexually transmitted diseases. Part I, Herpes, Syphilis, Urethritis, Chlamydia and Gonorrhea, appeared in the October 1 issue .
This article focuses on vaginal infections, pelvic inflammatory disease and genital warts, with brief mention of proctitis, enteritis and ectoparasitic infections. It should be noted that vaginal candidiasis and bacterial vaginosis are included in the following discussion, although these infections are not sexually transmitted. They are frequently diagnosed at the same time as sexually transmitted diseases , however, and the treatments often overlap.
Summary Of The Evidence
There is no evidence relating to patient values and preferences but the Guideline Development Group agreed that there is probably no variability in the values people place on the outcomes. Research related to other conditions indicates that adherence may be improved with simpler medication regimens. The GDG therefore agreed that azithromycin may be more acceptable to patients since it is a single dose regimen . There is little to no evidence for equity issues and feasibility. Resistance in other infections that often co-occur with chlamydia may restrict the use of some medicines, such as ofloxacin. For many of these medicines, costs may differ between countries in places with high incidence of chlamydia, the cost differences between azithromycin and doxycycline may be large due to greater numbers of people requiring treatment.
In summary, there was moderate quality evidence for trivial differences in benefits and harms between azithromycin and doxycycline, and although the cost of azithromycin is higher, the single dose may make it more convenient to use than doxycycline. While the differences are also trivial with the other medicines, the evidence is low quality and these are therefore provided as alternatives, with the exception of delayed-release doxycycline, which is currently expensive.
See for list of references of reviewed evidence, and for details of the evidence reviewed, including evidence profiles and evidence-to-decision frameworks .
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Treated With The Same Type Of Antibiotic
Sexually transmitted infections tend to be something that we dont like to talk about. Despite how common they are, there is still a stigma attached to STIs and a lot of shame and embarrassment around testing positive. Perhaps youre worried about how to tell your partner, or how previous partners will react to the news. Whatever happens, youve done the right thing in getting tested and being honest about it.
Gonorrhea and chlamydia are two common sexually transmitted infections. They are both caused by bacteria and treated with the same type of antibiotics. In many cases, they dont cause symptoms, especially with chlamydia, so its possible to have an STI without knowing. This is how theyre so easily spread, because there are no warning signs.
Order safe treatment for chlamydia
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Neisseria Gonorrhoeae Resistance Frequency
N. gonorrhoeae 49226 was tested against SPC or 1950 at 4× and 8× the MIC as determined by agar dilution testing. Aliquots of 40× stock solutions were mixed with GC medium agar1% IsoVitaleX to produce a molten agar-drug mixture that was either 4- or 8-fold the MIC. Mixture was poured into plates in duplicate and allowed to solidify at room temperature for at least 1 h. A dense cell suspension equivalent to 5 McFarland was prepared using bacterial growth from chocolate agar plates of N. gonorrhoeae ATCC 49226. This cell suspension provided the inoculum for the spontaneous mutation plates, targeting 109 CFU per plate. The viable count of each suspension was determined by plating serial 10-fold dilutions onto agar in duplicate. A 0.25-ml aliquot of inoculum was spread onto the surface of duplicate 150- by 15-mm test plates and allowed to dry. The plates were inverted and incubated at 35°C for 48 h. Plates were inspected for growth at both 24 and 48 h, and colony counts were determined manually. Using the counts at 48 h, the spontaneous mutation frequency was calculated using the following equation: average number of colonies from duplicate selection plates divided by total number of cells inoculated onto each plate. If there were no colonies on the antibiotic selection plates, the spontaneous mutation frequency was calculated as 1/inoculum to indicate that the spontaneous mutation frequency was less than the limit of detection .
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Other Approaches To Prevention
The USPSTF has issued recommendations on screening for other STIs, including hepatitis B, genital herpes, HIV, and syphilis. The USPSTF has also issued recommendations on behavioral counseling for all sexually active adolescents and for adults who are at increased risk for STIs. These recommendations are available at .
Whats The Worst That Could Happen
For women, a chlamydia infection can lead to Pelvic Inflammatory Disease , an infection of parts of the reproductive system like the uterus, ovaries, and fallopian tubes. That means if you have chlamydia and you dont get it treated, you might not be able to have babies if and when you want to. PID can also lead to problems like chronic pelvic pain or ectopic pregnancy.
In men, untreated chlamydia may spread to the testicles, causing pain, and in rare cases, infertility.
Chlamydia infection also increases your likelihood of getting HIV. Pregnant women who have chlamydia can pass it on to their babies during birth, which could cause blindness or lung damage.
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What Are Oral Chlamydia Symptoms
Like most STDs, partners exposed to chlamydia may exhibit no symptoms. Similarly, in oral chlamydia, most people have no symptoms. When symptoms arise, some experience a sore throat. While others, may experience redness of the throat. In any situation, if you or a partner have been exposed to someone who has chlamydia, it is best to get treated as soon as possible to avoid complications.
What Do I Need To Know If I Get Treated For Chlamydia
If youre getting treated for chlamydia:
- Take all of your medicine the way your nurse or doctor tells you to, even if any symptoms you may be having go away sooner. The infection stays in your body until you finish the antibiotics.
- Your partner should also get treated for chlamydia so you dont re-infect each other or anyone else.
- Dont have sex for 7 days. If you only have 1 dose of medication, wait for 7 days after you take it before having sex. If youre taking medicine for 7 days, dont have sex until youve finished all of your pills.
- Get tested again in 3-4 months to make sure your infection is gone.
- Dont share your medicine with anyone. Your nurse or doctor may give you a separate dose of antibiotics for your partner. Make sure you both take all of the medicine you get.
- Even if you finish your treatment and the chlamydia is totally gone, its possible to get a new chlamydia infection again if youre exposed in the future. Chlamydia isnt a one-time-only deal. So use condoms and get tested regularly.
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Does Amoxicillin Treat Std Infections Such As Gonorrhea
Now its time to discuss how to treat STDs with amoxicillin. Each STD is unique, so the treatment options will vary depending on the type of STD you have.
On the whole, gonorrhea tends to be treatable with common drugs such as penicillin, ampicillin, tetracycline and doxycycline. With several doses of amoxicillin or a similar drug, gonorrhea can be cured in a few days.
Antibiotics such as amoxicillin have been prescribed by doctors to treat gonorrhea in the past. Of course, even though Amoxicillin is one of the most well-known drugs, that doesnt mean that it is the primary drug of choice for treatment of gonorrhea. In fact, the Centers for Disease Control and Prevention recommends that uncomplicated gonorrhea be treated only with the antibiotic ceftriaxone given as an injection in combination with either azithromycin or doxycycline two antibiotics that are taken orally.
According to the CDC, this combination of prescription medications will successfully treat gonorrhea, but it will not repair permanent damage caused by this STD. For this reason, its important to seek medical treatment right away to ensure you can get rid of this infection before it causes permanent damage.
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Best Over The Counter Antibiotics To Treat Chlamydia
Want to treat Chlamydia without surgery? then, You should take some best rated over the counter antibiotics for same.
Often time when people became ill, they always go for a relief to seek for available medications at their local stores for prescriptions. Furthermore, their conditions are always minor and may not be life threatening. People use over-the-counter drugs, in treating beginning stages. Treating your STD in timely manner is very important, Whether you got chlamydia from toilet seat or you have chlamydia in your mouth.
Well, all these antibiotics have their various functions. They are just prescription, prescribe by your doctors and each and every one of them has what is does. They are all important, do not neglect anyone. All you have to do is to know the one that is needed for your problem. The most medical pharmacist can prescribe fully well than others.
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How Can You Test For Gonorrhea And Chlamydia At Home
You dont need to visit a lab, clinic, or doctors office to test for STDs. You can take this test in the comfort of your own home thanks to myLAB Box. Simply follow these steps:
- Order your STD panel kit online on the myLAB box website. Dont worry, we even include free shipping! We offer discreet shipping, which means your neighbors wont know you are receiving an STD test in the mail.
- Test yourself at any time and from any place using the easy-to-follow instructions. Your testing kit will include everything you need to complete the test. This part only takes five minutes!
- Send your samples back to the lab with the pre-paid return envelope that comes with your kit.
- Get results online in a matter of days. Results are typically sent within 2-5 days. Once you receive our email, you can log into a secure portal for your private results.
- If you test positive for gonorrhea or chlamydia, you have the option of scheduling a phone consultation with a medical professional to discuss your results. The physician will answer your questions, address your concerns, and help you understand what steps you need to take next.
Bonus!
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What Is The Treatment For Gonorrhea
Gonorrhea can be cured with the right treatment. CDC recommends a single dose of 500 mg of intramuscular ceftriaxone. Alternative regimens are available when ceftriaxone cannot be used to treat urogenital or rectal gonorrhea. Although medication will stop the infection, it will not repair any permanent damage done by the disease. Antimicrobial resistance in gonorrhea is of increasing concern, and successful treatment of gonorrhea is becoming more difficult. A test-of-cure follow-up testing to be sure the infection was treated successfully is not needed for genital and rectal infections however, if a persons symptoms continue for more than a few days after receiving treatment, he or she should return to a health care provider to be reevaluated. A test-of-cure is needed 7-14 days after treatment for people who are treated for a throat infection. Because re-infection is common, men and women with gonorrhea should be retested three months after treatment of the initial infection, regardless of whether they believe that their sex partners were successfully treated.
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How Long Does It Take
It takes about one week for azithromycin to completely cure a chlamydial infection, and in some cases it can take up to two weeks for the infection to clear.
If you are sexually active during this time, you can pass the infection to your partner, even if you have no symptoms. For these reasons, you should avoid having sex of any kind during treatment.
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Is Liability For Providers And Pharmacists Addressed In This Legislation
A health care provider who reasonably and in good faith renders EPT in accordance with Public Health Law section 2312 and section 23.4, and a pharmacist who reasonably and in good faith dispenses drugs pursuant to a prescription written in accordance with Public Health Law section 2312 and section 23.4, shall not be subject to civil or criminal liability or be deemed to have engaged in unprofessional conduct.
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What Happens If You Dont Get Treated For Gonorrhea
Even though gonorrhea is common and doesnt always cause symptoms, it can become a big deal if its not treated.
Gonorrhea can spread to your uterus and fallopian tubes, causing pelvic inflammatory disease . PID might not have any symptoms at first, but it can cause permanent damage that may lead to chronic pain, infertility, or ectopic pregnancy. Getting tested for gonorrhea really lowers your chances of getting PID.
Having gonorrhea also increases your chances of getting or spreading HIV, the virus that causes AIDS. Rarely, untreated gonorrhea may spread to your blood, skin, heart, or joints and lead to serious health problems, or even death.
If you have gonorrhea while youre pregnant and dont treat it, it can be passed to your baby when youre giving birth. This can lead to problems for the baby, including blindness, joint infections, or blood infections which can be deadly.
The best way to avoid all these problems? Get tested and treated early.
Drugs And Antibiotics For Chlamydia Trachomatis
In accordance with the latest international standards , the most effective drug for urogenital chlamydia is azithromycin a single dose or a 7-day course of doxycycline is used.
Treatment of uncomplicated chlamydiosis includes:
- azithromycin for infections of the urogenital tract caused by Chlamydia trachomatis . For the treatment of uncomplicated urethritis / cervicitis it is prescribed in a single dose of 1000 mg .
Medications containing azithromycin. Brand names: Zithromax, Azithromycin Dose Pack, Z-Pak, Zmax.
Medications containing doxycycline. Brand names: Vibramycin, Oracea, Adoxa, Monodox.
You are probably interested in the following question how soon can I have sex again?
If you had a one-day course of azithromycin, you should avoid sex at least for a week after the treatment.
Alternative drugs are other macrolides and fluoroquinolones. The safety profile allows pregnant women to use azithromycin . Other macrolides are not recommended for pregnancy .
In addition to antibiotics, the scheme of chlamydia treatment sometimes includes antifungal drugs , immunomodulators . In case of abundant secretions from the urethra, local antimicrobial agents are also used.
In some cases, additional treatment is prescribed .
In case of chronic chlamydia , antibiotic therapy is longer and often combined .
After 6-9 weeks after the end of the treatment the patient should carry out PCR again .
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Get Retested Following Treatment
Many people have more than one chlamydia infection. If youre a girl or woman and your sex partners are not treated for the infection, you will be at high risk for reinfection. Repeated infections with chlamydia make it much more likely that your ability to have children will be affected. Repeated infections also raise your risk of painful complications, such as pelvic inflammatory disease.
Both women and men with chlamydia should be retested about three months after they are first diagnosed and treated. Go to be retested even if you think your sex partners were successfully treated.
Reporting And Partner Notification
National/provincial/territorial notification
Gonococcal infections are nationally notifiable and reportable by laboratories, physicians and designated health professionals to local public health authorities in all provinces and territories.
Local public health authorities should be promptly notified of suspected or confirmed treatment failures. The prompt notification of treatment failures will allow provincial and territorial STI prevention and control programs to quickly identify emerging patterns of AMR in their jurisdictions. This will enable P/Ts to collaborate with the Public Health Agency of Canada to issue timely electronic alerts through the Canadian Network for Public Health Intelligence .
Partner notification
Case finding and partner notification are critical to the prevention and control of gonococcal infections. Notify, clinically assess, test and provide empiric treatment to all sexual partners of the index case within 60 days prior to symptom onset or date of specimen collection . Empiric treatment is indicated regardless of clinical findings and without waiting for test results)Footnote 4Footnote 42.
Extend the length of time for partner notification
- To include additional time up to the date of treatment
- If the index case states there were no partners during the recommended trace-back period
- If all partners traced test negative
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