Sandbox ID Genitourinary

Diseases Characterized by Genital, Anal, or Perianal Ulcers

Chancroid

Further information: Chancroid medical therapy and therapeutic approach

• Chancroid

• Preferred regimen: Azithromycin 1 g PO as a single dose OR Ceftriaxone 250 mg IM as a single dose OR Ciprofloxacin 500 mg PO bid for 3 days OR Erythromycin 500 mg PO tid for 7 days

Note: Ciprofloxacin is contraindicated for pregnant and lactating women. Patients should be tested for HIV infection at the time chancroid is diagnosed. If the initial test results were negative, a serologic test for syphilis and HIV infection should be performed 3 months after the diagnosis of chancroid.

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Gonococcal infection

Further information: Gonococcal infection medical therapy and therapeutic approach

• Gonococcal infection

• Uncomplicated Gonococcal Infections of the Cervix, Urethra, and Rectum

• Preferred regimen: Ceftriaxone 250 mg IM as a single dose AND (Azithromycin 1 g PO as a single dose OR Doxycycline 100 mg PO bid for 7 days)
• Alternative regimen: Cefuroxime 1 g PO as a single dose

• Uncomplicated Gonococcal Infections of the Pharynx

• Preferred regimen: Ceftriaxone 250 mg IM in a single dose AND (Azithromycin 1 g orally as a single dose OR Doxycycline 100 mg orally twice daily for 7 days)

• Gonococcal Conjunctivitis

• Preferred regimen: Ceftriaxone 1 g IM in a single dose

• Disseminated Gonococcal Infection (DGI)

• Preferred regimen: Ceftriaxone 1 g IV/IM every 24 hours
• Alternative regimen: Cefotaxime 1 g IV every 8 hours OR Ceftizoxime 1 g IV every 8 hours

Note: All of the preceding regimens should be continued for 24-48 hours after improvement begins, at which time therapy can be switched to Cefixime 400 mg PO bid to complete at least 1 week of antimicrobial therapy.

• Gonococcal Meningitis

• Preferred regimen: Ceftriaxone 1-2 g IV every 12 hours for 10-14 days

• Gonococcal Endocarditis

• Preferred regimen: Ceftriaxone 1-2 g IV every 12 hours for at least 4 weeks

• Gonococcal Infections Among Infants

• Ophthalmia Neonatorum Caused by N. gonorrhoeae

• Preferred regimen: Ceftriaxone 25-50 mg/kg IV or IM in a single dose, not to exceed 125 mg

• DGI and Gonococcal Scalp Abscesses in Newborns

• Preferred regimen:

Workowski, Kimberly A.; Berman, Stuart; Centers for Disease Control and Prevention (CDC) (2010-12-17). "Sexually transmitted diseases treatment guidelines, 2010". MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control. 59 (RR-12): 1–110. ISSN 1545-8601. PMID 21160459.

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