From the Guidelines
The standard treatment for sexually transmitted diseases (STDs) should be guided by the specific infection, with bacterial STDs like chlamydia and gonorrhea typically treated with antibiotics, and viral STDs managed with antiviral medications or other supportive care. The treatment approach may vary depending on the disease prevalence and characteristics of the medical practice setting 1. For instance, bacterial STDs like chlamydia can be effectively treated with a single dose of azithromycin (1g) or doxycycline (100mg twice daily for 7 days), while gonorrhea usually requires ceftriaxone (500mg intramuscular injection) plus azithromycin (1g orally) 1.
Some key considerations in STD treatment include:
- The importance of treating partners of patients to prevent reinfection 1
- The need for presumptive treatment in certain cases, such as men with urethral discharge and sexually active females with mucopurulent cervical discharge, who should be treated with antibiotics for gonorrhea and chlamydial infection 1
- The role of antiviral medications in managing viral STDs, such as genital herpes, which requires antiviral medications like acyclovir (400mg three times daily for 7-10 days for initial outbreaks, shorter for recurrences) 1
- The importance of lifelong antiretroviral therapy with multiple drug combinations for HIV treatment 1
It is crucial to prioritize the most recent and highest quality evidence when making treatment decisions, and to consider the specific context and patient population when selecting a treatment approach. In general, the goal of STD treatment is to cure the infection, prevent complications, and reduce the risk of transmission to others 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
StD Treatment Overview
- The treatment for gonorrhea has been updated to a single 500 mg intramuscular dose of ceftriaxone, as recommended by the CDC 2, 3, 4, 5.
- If chlamydial infection has not been excluded, concurrent treatment with doxycycline (100 mg orally twice a day for 7 days) is recommended 2, 4.
- The use of azithromycin is no longer recommended as a first-line treatment for gonorrhea due to increasing resistance 4, 5.
Treatment Efficacy
- Studies have shown that high-dose ceftriaxone monotherapy is effective for treating extragenital gonorrhea among men who have sex with men, with an efficacy rate of 98.1% 6.
- The efficacy of ceftriaxone monotherapy is comparable to dual therapy with azithromycin or doxycycline, with no significant difference in efficacy observed between the two groups 6.
Antimicrobial Resistance
- Neisseria gonorrhoeae has developed resistance to all first-line recommended therapies, making gonococcal antimicrobial resistance a major public health concern 4.
- The CDC recommends continuing to monitor for the emergence of ceftriaxone resistance through surveillance and healthcare providers' reporting of treatment failures 2, 4.