From the Guidelines
If you suspect you have an STD, you should seek immediate medical care from a healthcare provider who can properly diagnose your condition through testing and prescribe appropriate treatment. Self-medication for STDs is dangerous and ineffective. Different STDs require different antibiotics or antivirals at specific doses based on the infection type, severity, and your personal health factors. For example, chlamydia requires different treatment than gonorrhea or syphilis. Additionally, some STDs like herpes or HIV cannot be cured with antibiotics at all. Taking the wrong medication or incorrect dosage could lead to antibiotic resistance, ongoing infection, complications, and continued transmission to partners. Many STD clinics offer confidential, low-cost testing and treatment.
Key Considerations
- The most recent and highest quality study 1 provides guidance on prophylactic treatment recommendations for adolescent sexual assault victims, including regimens for gonorrhea, trichomonas, chlamydia, hepatitis B, human papillomavirus, and HIV.
- The use of ceftriaxone, 125 mg intramuscularly once, is recommended for gonorrhea prophylaxis 1.
- Azithromycin, 1 g orally once, or doxycycline, 100 mg orally twice daily for 7 d, is recommended for chlamydia prophylaxis 1.
- Metronidazole, 2 g orally once, is recommended for trichomonas prophylaxis 1.
Important Notes
- HIV prophylaxis is not universally recommended but should be considered when there is mucosal exposure (oral, vaginal, or anal) 1.
- Serum samples can be obtained for baseline testing for syphilis and HIV in areas or populations in which there is a high incidence of infection or if the victim wishes for these tests to be performed 1.
Final Recommendation
The only safe approach is to get properly tested and follow a healthcare provider's prescribed treatment plan.
From the FDA Drug Label
Adults: The usual dose of oral doxycycline is 200 mg on the first day of treatment (administered 100 mg every 12 hours) followed by a maintenance dose of 100 mg/day Uncomplicated gonococcal infections in adults (except anorectal infections in men):100 mg, by mouth, twice a day for 7 days. Uncomplicated urethral, endocervical, or rectal infection in adults caused by Chlamydia trachomatis: 100 mg, by mouth, twice a day for 7 days. Nongonococcal urethritis (NGU) caused by C. trachomatis or U. urealyticum: 100 mg, by mouth, twice a day for 7 days.
The recommended broad spectrum treatment dosage for possible STDs using doxycycline is:
- 100 mg, twice a day for 7 days for uncomplicated gonococcal infections, Chlamydia trachomatis, and nongonococcal urethritis (NGU) 2. Alternatively, ofloxacin can be used with the following dosage:
- 300 mg, twice a day for 7 days for nongonococcal cervicitis/urethritis due to C. trachomatis 3.
- 400 mg, single dose for acute, uncomplicated urethral and cervical gonorrhea 3.
From the Research
Broad Spectrum Treatment Dosage for Possible STD
- The Centers for Disease Control and Prevention (CDC) released guidelines for the treatment of sexually transmitted diseases in 1998, which included single-dose regimens for many STDs 4.
- For chancroid, a single-dose regimen of 1 g of oral azithromycin or 250 mg of intramuscular ceftriaxone is effective 4, 5.
- For syphilis, parenteral penicillin continues to be the drug of choice for treatment of all stages 4, 6.
- Azithromycin in a single oral 1-g dose is now a recommended regimen for the treatment of nongonococcal urethritis 4.
- Doxycycline is a broad-spectrum antimicrobial agent used in the management of several bacterial infections, including STDs 7.
- The recommended treatment for gonorrhea is ceftriaxone monotherapy given intramuscularly, with dosing based on the patient's body weight 6.
- For chlamydia, doxycycline is the preferred treatment 6, 7.
- Vaginal trichomoniasis should be treated with a seven-day regimen of metronidazole 6.
- Treatment of pelvic inflammatory disease routinely includes metronidazole with doxycycline and an increased dosage of ceftriaxone 6.
Specific Treatment Dosages
- Syphilis of less than one year's duration: a single dose of intramuscular penicillin G benzathine, 2.4 million units 6.
- Syphilis of more than one year's or unknown duration: three consecutive weekly doses of intramuscular penicillin G benzathine, 2.4 million units each 6.
- Gonorrhea: ceftriaxone monotherapy given intramuscularly, with dosing based on the patient's body weight 6.
- Chlamydia: doxycycline, 100 mg orally twice a day for 7 days 6, 7.