From the Guidelines
STIs should be treated promptly with antibiotics for bacterial infections, such as azithromycin, doxycycline, or penicillin, and antiviral medications for viral infections, such as herpes and HIV, to prevent complications and transmission to partners. The symptoms of STIs can vary, but common ones include genital ulcers, discharge, and pain during urination. If left untreated, STIs can lead to serious health problems, such as infertility, chronic pain, and increased cancer risk.
Common STIs and Treatment Options
- Chlamydia: can be treated with antibiotics such as azithromycin or doxycycline 1
- Gonorrhea: can be treated with antibiotics such as ceftriaxone or cefixime 1
- Syphilis: can be treated with antibiotics such as penicillin 1
- Herpes: can be managed with antiviral medications such as acyclovir or valacyclovir 1
- HIV: can be managed with antiretroviral therapy (ART) 1
Prevention Methods
- Consistent condom use
- Limiting sexual partners
- Regular STI testing
- Vaccination against HPV and hepatitis B 1
Importance of Early Treatment
Early treatment of STIs is crucial to prevent complications and transmission to partners. Many STIs can be asymptomatic, so regular screening is important, especially after unprotected sex or when beginning a new sexual relationship. Prompt medical attention is necessary if symptoms persist or worsen, and treatment should be guided by the most recent and highest quality evidence, such as the 2021 Centers for Disease Control and Prevention (CDC) STI treatment guidelines 1.
From the FDA Drug Label
Because genital herpes is a sexually transmitted disease, patients should avoid contact with lesions or intercourse when lesions and/or symptoms are present to avoid infecting partners. Genital herpes is frequently transmitted in the absence of symptoms through asymptomatic viral shedding. Therefore, patients should be counseled to use safer sex practices If episodic therapy for recurrent genital herpes is indicated, patients should be advised to initiate therapy at the first sign or symptom of an episode.
The symptoms of Sexually Transmitted Infections (STIs) such as genital herpes include lesions, itching, burning, and pain.
- Treatment options for STIs include:
- Antiviral medications such as valacyclovir and famciclovir for genital herpes
- Antibiotics such as azithromycin for bacterial STIs like chlamydia and gonorrhea
- Prevention of STIs includes practicing safer sex, avoiding contact with lesions or intercourse when symptoms are present, and using condoms.
- Patients with STIs should be counseled to use safer sex practices and initiate therapy at the first sign or symptom of an episode 2, 3.
- Azithromycin is used to treat certain bacterial STIs, but it should not be relied upon to treat syphilis, and patients should have a serologic test for syphilis and appropriate cultures for gonorrhea performed at the time of diagnosis 4.
From the Research
Symptoms of Sexually Transmitted Infections (STIs)
- STIs can cause a range of symptoms, including pelvic inflammatory disease, ectopic pregnancy, and infertility, as well as facilitate the transmission of human immunodeficiency virus (HIV) 5
- Some STIs, such as gonorrhea, can cause symptoms like deep, painful ulcerations in genital bite wounds 6
- Other STIs, like chlamydia, may not exhibit any symptoms at all, or may only exhibit mild symptoms 7
Treatment Options for STIs
- Effective treatment for gonococcal infections includes a single 500 mg intramuscular (IM) dose of ceftriaxone, and if chlamydial infection has not been excluded, concurrent treatment with doxycycline (100 mg orally twice a day for 7 days) is recommended 5
- Single-dose antibiotic regimens, such as azithromycin and ceftriaxone, are suitable for treating chancroid 6, 8
- Syphilis is best managed with single-dose benzathine penicillin G, while lymphogranuloma venereum is treated with prolonged courses of doxycycline or minocycline 6
- Antiviral medications, such as acyclovir, valacyclovir, and famciclovir, have been shown to provide clinical benefit in the treatment of genital herpes 8
- Expedited partner therapy for gonorrhea and chlamydia, as well as the provision of hepatitis B and human papillomavirus vaccines, can also be effective in preventing the spread of STIs 9
Management of Patients with STIs
- Management of STIs in the Emergency Department (ED) includes appropriate testing and treatment per CDC Sexually Transmitted Diseases Treatment Guidelines 7
- Pregnant women with STIs are particularly vulnerable to serious complications, and empiric ED treatment combined with close follow-up care and referral to obstetrics is paramount 7
- Improving care for STIs requires a public health response, and innovations in non-invasive diagnostic techniques have facilitated the expansion of STI testing and treatment outside traditional STI clinics 9